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将人口普查数据分配到普通医疗人群:对实践层面处方差异研究的影响。

Allocating census data to general practice populations: implications for study of prescribing variation at practice level.

作者信息

Scrivener G, Lloyd D C

机构信息

Prescribing Research Unit, University of Leeds.

出版信息

BMJ. 1995 Jul 15;311(6998):163-5. doi: 10.1136/bmj.311.6998.163.

Abstract

OBJECTIVES

To assign census data to general practice populations and to test accuracy of different procedures for estimating the proportion of patients aged over 64.

DESIGN

Patients' postcodes from patient register of one family health services authority and the directory linking postcodes to census enumeration districts were used to locate patients in their census area of residence. With different levels of census geography and four different allocation procedures, proportion of patients aged over 64 in each area was used to predict proportion of patients aged over 64 in each general practice. Predicted figures were compared with real figures from each practice register to assess accuracy of allocation methods.

SETTING

Data from 1991 census and from 73 practices administered by one family health services authority.

MAIN OUTCOME MEASURES

Actual and predicted proportions of patients aged over 64 in general practice populations.

RESULTS

Correlations between actual and predicted proportions of patients aged over 64 were significant for all four allocation procedures--values of 0.66, 0.7, 0.84, and 0.84 were achieved (P < 0.0005). Predicted ranges of proportions of patients aged over 64, however, were well short of those that actually existed, and significant differences existed between predicted percentages and actual figures for all four methods.

CONCLUSION

Although predicted values correlated with actual values, the failure of the allocation procedures to correctly predict values, especially at the extremes, casts doubt on the validity of similar techniques for allocating census variables to general practice populations.

摘要

目的

将人口普查数据应用于全科医疗人群,并测试不同程序估算64岁以上患者比例的准确性。

设计

利用一个家庭健康服务机构患者登记册中的患者邮政编码,以及将邮政编码与人口普查枚举区相联系的目录,来确定患者在其人口普查居住区域的位置。采用不同层级的人口普查地理信息和四种不同的分配程序,根据每个区域64岁以上患者的比例来预测每个全科医疗中64岁以上患者的比例。将预测数字与每个医疗机构登记册中的实际数字进行比较,以评估分配方法的准确性。

背景

数据来自1991年人口普查以及由一个家庭健康服务机构管理的73个医疗机构。

主要观察指标

全科医疗人群中64岁以上患者的实际比例和预测比例。

结果

对于所有四种分配程序,64岁以上患者实际比例与预测比例之间的相关性均显著——相关系数分别为0.66、0.7、0.84和0.84(P<0.0005)。然而,64岁以上患者比例的预测范围远低于实际存在的范围,并且所有四种方法的预测百分比与实际数字之间均存在显著差异。

结论

尽管预测值与实际值相关,但分配程序未能正确预测数值,尤其是在极端情况下,这使人对将人口普查变量分配给全科医疗人群的类似技术的有效性产生怀疑。

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