Lloyd D C, Harris C M, Clucas D W
Prescribing Research Unit, Leeds University Research School of Medicine.
BMJ. 1995 Jan 21;310(6973):165-9. doi: 10.1136/bmj.310.6973.165.
To describe and validate a new deprivation index, based on the percentage of prescribed items exempt from the prescription charge under the low income scheme, at both family health services authority and practice level.
Comparison of the index with three other deprivation indices and correlation of index values with the use of drugs given for conditions with known social class gradients.
All 90 family health services authorities and 7619/9289 practices in England.
The ranking of family health services authorities on the new index correlated highly with rankings on the other indices. Values in relation to the use of drugs given for conditions with known social class gradients were in the predicted direction at both family health services authority level and practice level; correlation was highly significant at the authority level, but less significant at practice level.
The new index provides a good measure of deprivation at family health services authority level, and at practice level the results are sufficiently encouraging to warrant further research. It provides the best available instrument for relating deprivation to the use of drugs in any population that can be defined by prescribing data, but an attempt to use it in determining allocation of resources would at this stage be premature.
在家庭健康服务机构及基层医疗单位层面,描述并验证一种基于低收入计划下免付处方费的规定项目百分比的新型贫困指数。
将该指数与其他三种贫困指数进行比较,并将指数值与针对已知社会阶层梯度疾病所使用药物的情况进行相关性分析。
英格兰所有90个家庭健康服务机构以及7619/9289个基层医疗单位。
家庭健康服务机构在新指数上的排名与其他指数的排名高度相关。在家庭健康服务机构层面和基层医疗单位层面,与针对已知社会阶层梯度疾病所使用药物相关的指数值均呈预期方向;在机构层面相关性非常显著,但在基层医疗单位层面相关性较弱。
新指数能很好地衡量家庭健康服务机构层面的贫困状况,在基层医疗单位层面的结果也足以令人鼓舞,值得进一步研究。它为将贫困状况与通过处方数据界定的任何人群的药物使用情况相关联提供了最佳可用工具,但现阶段试图将其用于确定资源分配还为时过早。