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社会经济地位是否会影响慢性病患者的医院利用和健康结果?

Does socioeconomic status affect hospital utilization and health outcomes of chronic disease patients?

机构信息

Melbourne Institute of Applied Economic and Social Research, The University of Melbourne, L5, 111 Barry Street, FBE Building, Parkville, VIC, 3010, Australia.

出版信息

Eur J Health Econ. 2021 Mar;22(2):329-339. doi: 10.1007/s10198-020-01255-z. Epub 2021 Jan 3.

Abstract

This study quantifies the extent socioeconomic status (SES) affects hospital utilization and adverse hospital events of chronic disease patients. After identifying the initial first-year spell of the disease, we examine six outcomes that include measures of utilization and incidence of adverse in-hospital events. Three years of hospital administrative data from the state of Victoria, Australia, are used to extract a sample of 237,743 patients with chronic disease spells. SES is measured using the utilization records of specific health and human services. The study finds that, compared to patients with no disadvantage, SES disadvantaged patients tend to incur higher hospital costs and longer utilization by about 20% and greater incidence of in-hospital adverse outcomes by up to 80% than non-disadvantaged patients. Further analysis shows that hospital adverse outcomes indirectly contribute to about a quarter of the observed difference in hospital costs between SES disadvantaged and non-disadvantaged patients.

摘要

这项研究量化了社会经济地位(SES)对慢性病患者住院利用和不良医院事件的影响程度。在确定疾病的初始年度病程后,我们检查了包括利用措施和住院不良事件发生率在内的六个结果。我们使用来自澳大利亚维多利亚州的三年医院管理数据,提取了 237743 名慢性病患者的样本。SES 是通过特定卫生和人类服务的利用记录来衡量的。研究发现,与无劣势的患者相比,SES 劣势患者的住院费用往往高出约 20%,利用时间延长约 20%,住院不良结果的发生率高出多达 80%。进一步的分析表明,医院不良结果间接导致 SES 劣势和非劣势患者之间观察到的医院费用差异的四分之一左右。

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