Chenet L, McKee M
Health Services Research Unit, London School of Hygiene and Tropical Medicine.
J Epidemiol Community Health. 1996 Jun;50(3):359-65. doi: 10.1136/jech.50.3.359.
To provide those working at district level with practical guidance on using hospital data linked to small geographic areas to explore patterns of care.
Examination of the association between age standardised hospital episode rates for the commonest diagnostic categories and deprivation levels (Carstairs index) of the electoral ward of residence.
An inner London district, Kensington, Chelsea and Westminster, with a population of approximately 325,000.
All finished consultant episodes recorded in NHS hospitals for the district population in the year to April 1994.
Many, but not all, disease categories were associated strongly with deprivation, with high episode rates in the most deprived electoral wards. This is partly due to more of those in deprived areas being admitted to hospital and to them being admitted more often.
A wide range of factors needs to be taken into account in interpreting these data. They include the contribution of the private sector and artifacts of both the numerator and denominator. This paper provides a framework for those working at district level to begin to analyse the association between hospitalisation and deprivation locally. It also identifies some of the issues that must be taken into account when seeking to interpret these data.
为地区层面的工作人员提供实用指南，指导他们如何利用与小地理区域相关联的医院数据来探究护理模式。
研究最常见诊断类别的年龄标准化医院发病率与居住选区贫困水平（卡斯尔斯指数）之间的关联。
伦敦市中心的一个区，肯辛顿、切尔西和威斯敏斯特，人口约32.5万。
1994年4月前一年中，国民保健服务体系（NHS）医院记录的该地区人口所有已完成的顾问医师诊疗病例。
许多但并非所有疾病类别都与贫困密切相关，最贫困的选区发病率较高。部分原因是贫困地区有更多人住院，且住院频率更高。
解读这些数据时需要考虑多种因素。这些因素包括私营部门的贡献以及分子和分母的人为因素。本文为地区层面的工作人员提供了一个框架，以便他们开始在当地分析住院与贫困之间的关联。它还指出了在试图解读这些数据时必须考虑的一些问题。
