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为何应将功能作为人群健康指标?关于一项智利人群研究的讨论。

Why Functioning Should Be Used as a Population Health Indicator? A Discussion of a Chilean Population Study.

作者信息

Barreto Marina Carvalho Arruda, Cartes-Velásquez Ricardo, Campos Valeria, Castaneda Luciana, Castro Shamyr Sulyvan

机构信息

Public Health Department, Federal University of Ceará, Fortaleza 60430-140, Brazil.

Facultad de Derecho y Ciencias Sociales, Universidad San Sebastián, Concepción 4080870, Chile.

出版信息

Healthcare (Basel). 2025 Jul 4;13(13):1606. doi: 10.3390/healthcare13131606.

Abstract

BACKGROUND/OBJECTIVES: Population health problems are among the world's main concerns. However, mortality and morbidity alone do not fully encompass the health experience of populations. International efforts are underway to verify health experiences using functioning as the third health indicator. The aim of the study was to compare the functioning profile of the Chilean population with mortality and morbidity rates due to neurological, circulatory, respiratory, and musculoskeletal diseases at the regional level.

METHODS

An ecological study was conducted with the secondary dataset II Estudio Nacional de la Discapacidad (ENDISC) and mortality and hospitalization rates from the Departamento de Estadísticas e Información en Salud. The II-ENDISC was a national household survey, based on the Model Disability Survey, carried out in 2015.

RESULTS

The correlation of functioning with morbidity and mortality rates was determined by Spearman's correlation. The correlation values of the mortality and morbidity coefficients with the performance and disability data were not relevant and significant ( < 0.35; > 0.05). This suggests a lack of a linear relationship between these indicators at the regional level.

CONCLUSIONS

The analysis of the Chilean population revealed that performance values, as an expression of functioning, do not correlate with morbidity or mortality rates. This discrepancy underscores the limitations of relying solely on traditional health indicators to capture the complexity of population health. Our findings support the conceptual value of functioning as a complementary and distinct health indicator, rather than a proxy for morbidity or mortality.

摘要

背景/目的:人口健康问题是全球主要关注的问题之一。然而,仅死亡率和发病率并不能完全涵盖人群的健康状况。国际社会正在努力将功能作为第三个健康指标来验证健康状况。本研究的目的是在区域层面比较智利人群的功能概况与神经、循环、呼吸和肌肉骨骼疾病的死亡率和发病率。

方法

利用二级数据集II《国家残疾研究》(ENDISC)以及卫生统计与信息部的死亡率和住院率进行了一项生态学研究。II-ENDISC是2015年基于《残疾调查模型》开展的一项全国家庭调查。

结果

功能与发病率和死亡率之间的相关性通过斯皮尔曼相关性确定。死亡率和发病率系数与表现和残疾数据的相关值不相关且不显著(<0.35;>0.05)。这表明在区域层面这些指标之间缺乏线性关系。

结论

对智利人群的分析表明,作为功能表达的表现值与发病率或死亡率不相关。这种差异凸显了仅依靠传统健康指标来反映人群健康复杂性的局限性。我们的研究结果支持功能作为一个补充性且独特的健康指标的概念价值,而非发病率或死亡率的替代指标。

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