Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
Program in Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
BMC Public Health. 2018 May 29;18(1):665. doi: 10.1186/s12889-018-5583-6.
Socioeconomic status (SES) is a well-established determinant of health status and home ownership is a commonly used composite indicator of SES. Patients in low-income households often stay in public rental housing. The association between public rental housing and mortality has not been examined in Singapore.
A retrospective, cohort study was conducted involving all patients who utilized the healthcare facilities under SingHealth Regional Health (SHRS) Services in Year 2012. Each patient was followed up for 5 years. Patients who were non-citizens or residing in a non-SHRS area were excluded from the study.
A total of 147,004 patients were included in the study, of which 7252 (4.9%) patients died during the study period. The mean age of patients was 50.2 ± 17.2 years old and 7.1% (n = 10,400) of patients stayed in public rental housing. Patients who passed away had higher utilization of healthcare resources in the past 1 year and a higher proportion stayed in public rental housing (p < 0.001). They also had higher rates of co-morbidities such as hypertension, hyperlipidaemia and diabetes. (p < 0.001) After adjustment for demographic and clinical covariates, residence in public rental housing was associated with increased risk of all-cause mortality (Adjusted hazard ratio: 1.568, 95% CI: 1.469-1.673).
Public rental housing was an independent risk factor for all-cause mortality. More studies should be conducted to understand health-seeking behavior and needs of public rental housing patients, to aid policymakers in formulating better plans for improving their health outcomes.
社会经济地位（SES）是健康状况的一个既定决定因素，而住房自有率是 SES 的常用综合指标。低收入家庭的患者通常居住在公共租赁住房中。在新加坡，尚未研究公共租赁住房与死亡率之间的关系。
进行了一项回顾性队列研究，该研究涉及 2012 年在 SingHealth Regional Health（SHRS）服务下使用医疗设施的所有患者。每位患者随访 5 年。从研究中排除了非公民或居住在非 SHRS 地区的患者。
共纳入 147004 例患者，其中 7252 例（4.9%）患者在研究期间死亡。患者的平均年龄为 50.2±17.2 岁，7.1%（n=10400）的患者居住在公共租赁住房中。去世的患者在过去 1 年中更多地利用了医疗资源，且有更高的比例居住在公共租赁住房中（p<0.001）。他们还患有更多的合并症，如高血压、高血脂和糖尿病。（p<0.001）。在调整人口统计学和临床协变量后，居住在公共租赁住房与全因死亡率增加相关（调整后的危险比：1.568，95%CI：1.469-1.673）。
公共租赁住房是全因死亡率的独立危险因素。应开展更多研究，以了解公共租赁住房患者的寻医行为和需求，帮助决策者制定改善其健康结果的更好计划。
