Department of Epidemiology, Health Economics and Public Health, Toulouse University Hospital, 37, Allées Jules Guesde, 31000, Toulouse, France.
LEASP UMR1027, INSERM-Université Toulouse III, 31000, Toulouse, France.
Int J Public Health. 2018 Apr;63(3):397-407. doi: 10.1007/s00038-017-1073-3. Epub 2018 Jan 13.
To analyse the association between patients' socioeconomic position (SEP) and the use of emergency departments (EDs).
This population-based study included all visits to ED in 2012 by inhabitants of the French Midi-Pyrénées region, recorded by the Regional Emergency Departments Observatory. We compared ED visit rates and the proportion of non-severe visits according to the patients' SEP as assessed by the European Deprivation Index.
We analysed 496,388 visits. The annual ED visit rate increased with deprivation level: 165.9 [95% CI (164.8-166.9)] visits per 1000 inhabitants among the most advantaged group, compared to 321.9 [95% CI (320.3-323.5)] per 1000 among the most disadvantaged. However, the proportion of non-severe visits was about 14% of the visits, and this proportion did not differ according to SEP.
Although the study shows a difference of ED visit rates, the probability of a visit being non-severe is not meaningfully different according to SEP. This supports the assumption that ED visit rate variations according to SEP are mainly explained by SEP-related differences in health states rather than SEP-related differences in health behaviours.
分析患者社会经济地位（SEP）与急诊科（ED）使用之间的关联。
本基于人群的研究纳入了 2012 年法国米迪-庇里牛斯地区所有居民因急症前往 ED 的记录，由地区急诊科观察站记录。我们根据欧洲剥夺指数评估患者的 SEP，比较 ED 就诊率和非严重就诊的比例。
我们分析了 496388 次就诊。ED 年就诊率随剥夺程度而增加：最具优势组每 1000 名居民中 165.9[95%CI(164.8-166.9)]次就诊，而最弱势群体每 1000 名居民中 321.9[95%CI(320.3-323.5)]次就诊。然而，非严重就诊的比例约为就诊的 14%，且这一比例与 SEP 无关。
尽管该研究显示 ED 就诊率存在差异，但就诊非严重程度的概率与 SEP 无关。这支持了 ED 就诊率根据 SEP 变化主要是由 SEP 相关的健康状况差异而非 SEP 相关的健康行为差异解释的假设。
