Oyarte Marcela, Delgado Iris, Pedrero Víctor, Agar Lorenzo, Cabieses Báltica
Universidad del Desarrollo. Facultad de Medicina Clínica Alemana. Santiago, Chile.
Universidad de Chile. Facultad de Medicina. Santiago, Chile.
Rev Saude Publica. 2018 Apr 9;52:36. doi: 10.11606/S1518-8787.2018052000222.
To compare cancer hospital morbidity among the local population and the immigrant population in Chile.
This is a prevalence study based on the analysis of hospital discharges of all the health centers of Chile. Cancer hospital discharges were characterized in 2012 according to the migratory status. The crude and specific rates of hospital morbidity for this cause were estimated for the analysis of their association with migratory status using zero-inflated negative binomial regression, adjusted for sociodemographic variables.
The neoplasms were the third cause of hospital discharges for immigrants and the seventh one for Chileans. The adjusted rate of cancer hospital discharges was higher for Chileans than immigrants, and the latter had fewer days of hospitalization and greater proportion of surgical interventions. In the group of immigrants, cancer hospital discharges mainly corresponded to patients belonging to the private system (46%), and in the group of Chileans they mainly corresponded to patients in the public system (71.1%). We observed a large difference in the proportion of cancer hospital discharges for patients with no health insurance between the two populations (22.6%: immigrants, 1.0%: Chileans). In both populations, the three most frequent types of cancer were: (i) lymphoid tissue, hematopoietic organs, and related tissues, (ii) digestive organs, and (iii) breast cancer.
Models of differentiated care should be considered for immigrants, with the creation of specific programs of information, coverage, and protection against cancer. More information on this problem must be generated at the local and international level.
比较智利当地人口和移民人口中的癌症医院发病率。
这是一项基于智利所有医疗中心出院记录分析的患病率研究。根据移民身份对2012年癌症医院出院情况进行特征描述。估计该病因的医院发病率粗率和特定率,使用零膨胀负二项回归分析其与移民身份的关联,并对社会人口学变量进行调整。
肿瘤是移民出院的第三大原因,是智利人出院的第七大原因。智利人的癌症医院出院调整率高于移民,后者住院天数更少,手术干预比例更高。在移民群体中,癌症医院出院主要对应于私立系统的患者(46%),而在智利人群体中,主要对应于公立系统的患者(71.1%)。我们观察到两个人群中无医疗保险患者的癌症医院出院比例存在很大差异(移民为22.6%,智利人为1.0%)。在两个人群中,最常见的三种癌症类型是:(i)淋巴组织、造血器官及相关组织,(ii)消化器官,(iii)乳腺癌。
应考虑为移民制定差异化护理模式,创建针对癌症的信息、覆盖范围和保护的特定项目。必须在地方和国际层面生成更多关于这个问题的信息。