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澳大利亚原住民和托雷斯海峡岛民身心多病的流行病学及其影响:一项全国代表性样本的横断面分析。

Epidemiology of physical-mental multimorbidity and its impact among Aboriginal and Torres Strait Islander in Australia: a cross-sectional analysis of a nationally representative sample.

机构信息

Nossal Institute for Global Health, The University of Melbourne, Melbourne, Victoria, Australia.

Nossal Institute for Global Health, The University of Melbourne, Melbourne, Victoria, Australia

出版信息

BMJ Open. 2022 Oct 11;12(10):e054999. doi: 10.1136/bmjopen-2021-054999.

Abstract

OBJECTIVES

This study aimed to examine the differences in multimorbidity between Aboriginal and Torres Strait Islander people and non-Indigenous Australians, and the effect of multimorbidity on health service use and work productivity.

SETTING

Cross-sectional sample of the Household, Income and Labour Dynamics in Australia wave 17.

PARTICIPANTS

A nationally representative sample of 16 749 respondents aged 18 years and above.

OUTCOME MEASURES

Multimorbidity prevalence and pattern, self-reported health, health service use and employment productivity by Indigenous status.

RESULTS

Aboriginal respondents reported a higher prevalence of multimorbidity (24.2%) compared with non-Indigenous Australians (20.7%), and the prevalence of mental-physical multimorbidity was almost twice as high (16.1% vs 8.1%). Multimorbidity pattern varies significantly among the Aboriginal and non-Indigenous Australians. Multimorbidity was associated with higher health service use (any overnight admission: adjusted OR=1.52, 95% CI=1.46 to 1.58), reduced employment productivity (days of sick leave: coefficient=0.25, 95% CI=0.19 to 0.31) and lower perceived health status (SF6D score: coefficient=-0.04, 95% CI=-0.05 to -0.04). These associations were found to be comparable in both Aboriginal and non-Indigenous populations.

CONCLUSIONS

Multimorbidity prevalence was significantly greater among Aboriginal and Torres Strait Islanders compared with the non-Indigenous population, especially mental-physical multimorbidity. Strategies are required for better prevention and management of multimorbidity for the aboriginal population to reduce health inequalities in Australia.

摘要

目的

本研究旨在探讨原住民和托雷斯海峡岛民与非原住民澳大利亚人之间多种疾病的差异,以及多种疾病对卫生服务利用和工作生产力的影响。

设置

澳大利亚家庭、收入和劳动力动态调查第 17 波的横断面样本。

参与者

年龄在 18 岁及以上的全国代表性样本 16749 名受访者。

结果测量

根据原住民身份衡量多种疾病的患病率和模式、自我报告的健康状况、卫生服务的利用和就业生产力。

结果

与非原住民澳大利亚人(20.7%)相比,原住民受访者报告的多种疾病患病率(24.2%)更高,而且精神-身体多种疾病的患病率几乎高出一倍(16.1%比 8.1%)。原住民和非原住民澳大利亚人之间的多种疾病模式差异显著。多种疾病与更高的卫生服务利用(任何过夜入院:调整后的 OR=1.52,95%CI=1.46 至 1.58)、就业生产力降低(病假天数:系数=0.25,95%CI=0.19 至 0.31)和较低的健康感知状态(SF6D 评分:系数=-0.04,95%CI=-0.05 至 -0.04)相关。在原住民和非原住民人群中,这些关联被发现是相当的。

结论

与非原住民人口相比,原住民和托雷斯海峡岛民的多种疾病患病率明显更高,尤其是精神-身体多种疾病。需要制定策略,更好地预防和管理原住民的多种疾病,以减少澳大利亚的健康不平等。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/681a/9557280/2e666dabbc49/bmjopen-2021-054999f01.jpg

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