Marín N, Caba A, Ortiz B, Pérez-Tornero E, Martínez L, López M, Fornieles H, Delgado-Rodríguez M
Servicio de Medicina Interna, Hospital Torrecárdenas, Universidad de Cantabria.
Med Clin (Barc). 1997 May 17;108(19):726-9.
Socioeconomic level is a key determinant for health status. It may also influence on the utilization of hospital emergency services, although the factor responsible for that is not known. The main objective of the present report is to assess whether patients using frequently hospital emergency services have one or more variables related to low socioeconomic level.
A standardized questionnaire was applied to 800 patients randomly selected from those attending the emergency services of a provincial reference hospital. It was gathered information on: income, education level, employment, loneliness, domestic violence, occupational accidents, and life style. Odds ratios (OR) and their 95% confidence intervals (CI) were estimated. Stepwise logistic regression analysis was used to ascertain the independent predictors for attending for than once to the emergency services.
In crude analysis, low income and low educational level were significantly related to the use of emergency services (both chi 2 for a trend < 0.05). Alcoholism (OR = 2.3, 95% CI = 1.2-4.7) and domestic violence (OR = 2.6, 95% CI = 0.9-8.1) were also related. Stepwise logistic regression analysis selected income (OR for intermediate level = 1.6, 95% CI = 1.0-2.7, and OR for low level = 2.3, 95% CI = 1.4-3.7) and alcoholism (OR = 2.9, 95% CI = 1.3-6.4) as independent predictors.
Patients with low income and/or alcoholism use emergency hospital services more frequently.
社会经济水平是健康状况的关键决定因素。它也可能影响医院急诊服务的利用情况，尽管其背后的因素尚不清楚。本报告的主要目的是评估频繁使用医院急诊服务的患者是否有一个或多个与低社会经济水平相关的变量。
对从一家省级参考医院急诊服务就诊患者中随机抽取的800名患者应用标准化问卷。收集了以下信息：收入、教育水平、就业、孤独感、家庭暴力、职业事故和生活方式。估计优势比（OR）及其95%置信区间（CI）。采用逐步逻辑回归分析确定急诊服务就诊不止一次的独立预测因素。
在粗分析中，低收入和低教育水平与急诊服务的使用显著相关（两者趋势χ2均<0.05）。酗酒（OR = 2.3，95%CI = 1.2 - 4.7）和家庭暴力（OR = 2.6，95%CI = 0.9 - 8.1）也与之相关。逐步逻辑回归分析选择收入（中等水平OR = 1.6，95%CI = 1.0 - 2.7，低水平OR = 2.3，95%CI = 1.4 - 3.7）和酗酒（OR = 2.9，95%CI = 1.3 - 6.4）作为独立预测因素。
低收入和/或酗酒的患者更频繁地使用医院急诊服务。
