From the Medical Physics and Bioengineering Department, St James's Hospital, Dublin 8, Ireland
Department of Internal Medicine, St James's Hospital, Dublin 8, Ireland.
QJM. 2016 Oct;109(10):645-651. doi: 10.1093/qjmed/hcw029. Epub 2016 Mar 9.
Deprivation Status increases the annual admission incidence of emergency medical admissions; the extent to which deprivation influences the admission of older persons is less well known.
To examine whether deprivation within a hospital catchment area influences emergency medical admissions for the elderly population.
The relationship between Deprivation Status, Dependency Ratio (population proportion of non-working age (<15 or ≥65 years) and age for all emergency admissions (82 368 episodes of 44 628 patients), over a 13-year period, were examined and ranked by quintile.
Univariate and multi-variable risk estimates (incidence rate ratios) were calculated, using truncated Poisson regression.
The Dependency Ratio and the Deprivation index independently predicted the annual incidence rate of medical emergencies; however, when calculated for older persons, the corresponding incidence rate ratios showed a falling trend with increasing Deprivation Status-Q2 0.51 (95% confidence interval [CI]: 0.50, 0.52), Q3 0.59 (95% CI: 0.58, 0.60), Q4 0.51 (95% CI: 0.50, 0.52) and Q5 0.37 (95% CI: 0.36, 0.38). Thus, with increasing Deprivation Status, the proportion of total admission from the ≥65-year cohort fell substantially.
The admission incidence rate for emergency medical patients is strongly influenced by the catchment area Deprivation Status. However, because of its greater impact on the younger population, increasing deprivation alters the ratio of younger to older persons as a proportion of total emergency admissions.
贫困状况会增加急诊医疗入院的年度发病率；贫困对老年人入院的影响程度则知之甚少。
研究医院服务区的贫困状况是否会影响老年人群的急诊医疗入院率。
在 13 年的时间里，研究了贫困状况、依赖比（非劳动年龄人口比例（<15 或≥65 岁）与所有急诊入院患者的年龄（44628 例患者中的 82368 例）之间的关系，并按五分位数进行了排名。
使用截断泊松回归计算了单变量和多变量风险估计（发病率比）。
依赖比和贫困指数独立预测了急诊医疗的年度发病率；然而，当针对老年人计算时，相应的发病率比随着贫困状况的增加呈下降趋势，Q2 为 0.51（95%置信区间[CI]：0.50，0.52），Q3 为 0.59（95% CI：0.58，0.60），Q4 为 0.51（95% CI：0.50，0.52），Q5 为 0.37（95% CI：0.36，0.38）。因此，随着贫困状况的增加，≥65 岁队列的总入院人数比例大幅下降。
急诊医疗患者的入院发病率受到服务区贫困状况的强烈影响。然而，由于其对年轻人口的影响更大，贫困程度的增加改变了年轻人口与老年人口在总急诊入院人数中的比例。
