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低收入母亲的社会福利金与急性损伤

Social benefit payments and acute injury among low-income mothers.

作者信息

Redelmeier Donald A, Chan William K, Mullainathan Sendhil, Shafir Eldar

机构信息

Sunnybrook Health Sciences Centre, G-151, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada.

出版信息

Open Med. 2012 Jul 31;6(3):e101-8. Print 2012.

Abstract

BACKGROUND

Human error due to risky behaviour is a common and important contributor to acute injury related to poverty. We studied whether social benefit payments mitigate or exacerbate risky behaviours that lead to emergency visits for acute injury among low-income mothers with dependent children.

METHODS

We analyzed total emergency department visits throughout Ontario to identify women between 15 and 55 years of age who were mothers of children younger than 18 years, who were living in the lowest socio-economic quintile and who presented with acute injury. We used universal health care databases to evaluate emergency department visits during specific days on which social benefit payments were made (child benefit distribution) relative to visits on control days over a 7-year interval (1 April 2003 to 31 March 2010).

RESULTS

A total of 153 377 emergency department visits met the inclusion criteria. We observed fewer emergencies per day on child benefit payment days than on control days (56.4 v. 60.1, p = 0.008). The difference was primarily explained by lower values among mothers age 35 years or younger (relative reduction 7.29%, 95% confidence interval [CI] 1.69% to 12.88%), those living in urban areas (relative reduction 7.07%, 95% CI 3.05% to 11.10%) and those treated at community hospitals (relative reduction 6.83%, 95% CI 2.46% to 11.19%). No significant differences were observed for the 7 days immediately before or the 7 days immediately after the child benefit payment.

INTERPRETATION

Contrary to political commentary, we found that small reductions in relative poverty mitigated, rather than exacerbated, risky behaviours that contribute to acute injury among low-income mothers with dependent children.

摘要

背景

因危险行为导致的人为错误是与贫困相关的急性损伤的常见且重要原因。我们研究了社会福利金支付是否会减轻或加剧导致有受抚养子女的低收入母亲因急性损伤而前往急诊就诊的危险行为。

方法

我们分析了安大略省所有的急诊就诊情况,以确定年龄在15至55岁之间、孩子年龄小于18岁、生活在社会经济最底层五分之一且因急性损伤就诊的母亲。我们使用全民医疗保健数据库来评估在特定的社会福利金支付日(儿童福利发放日)的急诊就诊情况,并与7年期间(2003年4月1日至2010年3月31日)的对照日就诊情况进行比较。

结果

共有153377次急诊就诊符合纳入标准。我们观察到,儿童福利金支付日的每日急诊次数少于对照日(56.4对60.1,p = 0.008)。这种差异主要是由35岁及以下的母亲、居住在城市地区的母亲以及在社区医院接受治疗的母亲的急诊次数减少所致(相对减少7.29%,95%置信区间[CI]为1.69%至12.88%)、(相对减少7.07%,95%CI为3.05%至11.10%)以及(相对减少6.83%,95%CI为2.46%至11.19%)。在儿童福利金支付日前7天或后7天未观察到显著差异。

解读

与政治评论相反,我们发现相对贫困的小幅减少减轻了而非加剧了导致有受抚养子女的低收入母亲发生急性损伤的危险行为。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9ac/3654504/ecbb2646d6d6/OpenMed-06-e101-g001.jpg

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