Fleming D M, Charlton J R
Birmingham Research Unit, Royal College of General Practitioners, Birmingham B17 9DB.
BMJ. 1998 May 23;316(7144):1572-6. doi: 10.1136/bmj.316.7144.1572.
To identify and consider differences in morbidity in children in households with one adult presenting to general practitioners compared with children in households with more than one adult.
Observational study; data analysed with logistic regression controlling for age, sex, and practice.
93 356 children aged 0-15 years included in the fourth national study of morbidity in general practice and for whom data about household structure were available. Among them 10 983 (11.8%) were living in households with a sole adult.
Morbidity data were recorded from each consultation as the assessment diagnosis made by the general practitioner.
Number of consultations and consultations per person for any illness, infections, acute respiratory infections, asthma, and accidents; number presenting and mean consultations per person for immunisation; number receiving home visits and home visits per person visited; average annual frequency of consultation among those consulting.
Compared with children in other households, a higher proportion of children in households with one adult consulted for infections and accidents. The proportion consulting for immunisation was lower and the proportion receiving home visits greater. Mean numbers of consultations per person consulting were also generally higher for all conditions. For infections, accidents, and home visits, the differences were evident in all age groups.
The study confirms the importance of single parent families as an indicator of deprivation. Children in such families should be targeted for immunisation and accident prevention.
确定并考量仅有一名成年人的家庭中的儿童与有多名成年人的家庭中的儿童在发病率方面的差异。
观察性研究;采用逻辑回归分析数据,并对年龄、性别和医疗机构进行控制。
93356名0至15岁儿童,纳入第四次全科医疗发病率全国性研究且可获取家庭结构数据。其中10983名(11.8%)生活在仅有一名成年人的家庭中。
每次诊疗时记录发病率数据,作为全科医生做出的评估诊断。
因任何疾病、感染、急性呼吸道感染、哮喘和事故的诊疗次数及人均诊疗次数;免疫接种的就诊人数及人均诊疗次数;接受家访的人数及人均家访次数;就诊者的年均诊疗频率。
与其他家庭中的儿童相比,仅有一名成年人的家庭中的儿童因感染和事故就诊的比例更高。免疫接种的就诊比例更低,接受家访的比例更高。所有情况下,就诊者的人均诊疗次数总体上也更高。对于感染、事故和家访,各年龄组的差异均很明显。
该研究证实单亲家庭作为贫困指标的重要性。此类家庭中的儿童应成为免疫接种和事故预防的目标对象。