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[年龄和性别对初级卫生保健各类利用情况的影响]

[Influence of age and sex on various types of utilization of the primary health care].

作者信息

Bellón Saameño J A, Delgado Sánchez A, Luna del Castillo J de D, Lardelli Claret P

机构信息

Departamento de Bioestradística, Universidad de Granada.

出版信息

Gac Sanit. 1995 Nov-Dec;9(51):343-53.

PMID:8666513
Abstract

OBJECTIVE

To find out the influence of gender and age on various types of utilization of primary care services.

METHOD

A random sample group containing 2662 patients over 14 years of age was observed over a continuous period of a year. Having already excluded the losses subjects, health service utilization was measured using patients whose clinical records had previously been validated.

RESULTS

A small number of patients (15%) use a disproportionate amount of the total number of visits. A numerical breakdown shows: 43% of global visits (GV), 45% of acute clinical visits (ACV), 68% administrative visits (AV) and 94% programmed visits (PV). The ACV, PV and GV were significantly higher in woman (p = 0.000), though in the AV was not the case. These remained a significant difference when age was controlling factor. The coefficients of correlation between age and the logarithm of the ACV, AV, PV and GV were respectively 0.27, 0.23, 0.40 and 0.41. Gender is not a consideration with regard to use of health services below 35 and above 75 years of age. In multiple lineal regression equations age stands out as the most predictive variable, followed by gender, excluding the AV where the doctor comes before gender.

CONCLUSION

A small group of highusers use a desproportionate amount of the total number of visits, particularly the AV and PV. The positive correlation between age and utilization is more clear by the PV and GV. The female is more user than the male, specially among 35 and 75 years old; although the gender is not determinant by the AV. There is not much explained variability with the age and gender, but the age is more important than the gender on utilization.

摘要

目的

了解性别和年龄对各类基层医疗服务利用情况的影响。

方法

对一个包含2662名14岁以上患者的随机样本组进行了为期一年的连续观察。在排除失访对象后,使用临床记录先前已得到验证的患者来衡量医疗服务利用情况。

结果

少数患者(15%)就诊次数占总就诊次数的比例过高。具体数字细分为:全球就诊(GV)的43%、急性临床就诊(ACV)的45%、行政就诊(AV)的68%和计划就诊(PV)的94%。女性的ACV、PV和GV显著更高(p = 0.000),但AV并非如此。当年龄作为控制因素时,这种差异仍然显著。年龄与ACV、AV、PV和GV对数之间的相关系数分别为0.27、0.23、0.40和0.41。在35岁以下和75岁以上人群中,性别对医疗服务利用情况没有影响。在多元线性回归方程中,年龄是最具预测性的变量,其次是性别,但AV除外,在AV方面医生比性别更重要。

结论

一小部分高就诊量患者的就诊次数占总就诊次数的比例过高,尤其是AV和PV。年龄与利用情况之间的正相关在PV和GV方面更为明显。女性比男性就诊更多,特别是在35岁至75岁之间;尽管性别对AV没有决定性影响。年龄和性别对利用情况的解释变异性不大,但年龄在利用情况方面比性别更重要。

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