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维多利亚州慢性阻塞性肺疾病的住院率和死亡率:按社会经济地位的差异分析

Chronic obstructive pulmonary disease hospitalisations and mortality in Victoria: analysis of variations by socioeconomic status.

作者信息

Ore Timothy, Ireland Paul

机构信息

Department of Health, Commission for Hospital Improvement, Victoria.

出版信息

Aust N Z J Public Health. 2015 Jun;39(3):243-9. doi: 10.1111/1753-6405.12305. Epub 2015 Jan 5.

Abstract

OBJECTIVE

This paper analysed chronic obstructive pulmonary disease (COPD) hospitalisations, unplanned readmissions and deaths in Victoria to identify associations with socioeconomic status (SES).

METHODS

The data was taken from the Victorian Admitted Episodes Dataset, the Victorian Health Information Surveillance System, the Victorian Burden of Disease Study and the Australian Bureau of Statistics' Index of Relative Socioeconomic Disadvantage.

RESULTS

COPD separations have a greater variation by SES than all separations. The average age-standardised separation rate (10.43) for the top percentile Local Government Areas (LGA) was 5.8 times that of the bottom percentile LGAs (1.80). The top percentile group was the lowest SES group (effect size = 0.93). There were significant negative correlations between the age-standardised COPD separation rates and SES across LGAs (r = -0.60) and Regions (r = -0.89). Analysis of readmissions (r = -0.49), mortality data (r = -0.51) and the burden of disease data (r = -0.39) also showed significant inverse associations between COPD and SES.

CONCLUSIONS AND IMPLICATIONS

Victorians living in the most disadvantaged areas have a greater burden from COPD, highlighting a need to prioritise public health services interventions to improve outcomes.

摘要

目的

本文分析了维多利亚州慢性阻塞性肺疾病(COPD)的住院情况、非计划再入院情况及死亡情况,以确定与社会经济地位(SES)之间的关联。

方法

数据取自维多利亚州住院病例数据集、维多利亚州健康信息监测系统、维多利亚州疾病负担研究以及澳大利亚统计局的相对社会经济劣势指数。

结果

COPD的出院情况在社会经济地位方面的差异比所有出院情况的差异更大。最高百分位地方政府区域(LGA)的平均年龄标准化出院率(10.43)是最低百分位LGA(1.80)的5.8倍。最高百分位组是社会经济地位最低的组(效应大小 = 0.93)。在各LGA(r = -0.60)和各区域(r = -0.89)中,年龄标准化COPD出院率与社会经济地位之间存在显著的负相关。对再入院情况(r = -0.49)、死亡率数据(r = -0.51)和疾病负担数据(r = -0.39)的分析也显示,COPD与社会经济地位之间存在显著的负相关。

结论与启示

生活在最贫困地区的维多利亚人患COPD的负担更重,这凸显了优先开展公共卫生服务干预措施以改善结局的必要性。

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