患者による社会リスクと HOUSES インデックスとの関連: 田舎と都市の比較
Jessica L Sosso1, Karen M Fischer2, Chung-Il Wi2
1Mayo Clinic Health System, Sparta, WI, USA.
Journal of primary care & community health
|September 2, 2025
まとめ
社会的リスク要因は農村部ではより多く見られるが,これは主に農村部そのものではなく,HOUSES指数で測定される社会経済的地位 (SES) に起因する. HOUSESインデックスは リスクの高い患者を 効果的に特定します
科学分野:
- 主要な医療研究
- 健康の社会的決定因子
- 健康 の 格差
背景:
- 社会的なリスク要因は 患者の健康に大きく影響します
- 社会経済的地位 (SES) を評価することは,健康上の格差を理解するために極めて重要です.
- HOUSESインデックスは,住宅データを用いたSES評価のための新しい方法を提供します.
研究 の 目的:
- 患者の報告した社会的リスク因子の流行を 農村部での初等医療環境で 決定する.
- この集団における社会経済的地位 (SES) を評価する HOUSES インデックスの有用性を評価する.
- 社会的リスク,HOUSES インデックス,および農村との関係を調べる.
主な方法:
- アメリカ中西部で成人のプライマリケア患者の横断分析.
- SES四分位数ランキングの患者住所に基づく HOUSES インデックスを利用した.
- 医療記録から収集された社会的リスクデータ (住居,食料,交通,財政,暴力)
- アソシエーションを分析するために混合効果モデルを使用した.
主要な成果:
- 農村部に住む患者は,すべての社会的リスク因子の有病率が高く,SES (HOUSES四分位数) が低いと報告した.
- HOUSES インデックス四分位は,社会的リスク因子の有意な予測因子であった (OR=2.27).
- HOUSES指数 (OR=1.02) を調整したところ,農村地域は社会リスクと独立して関連していない.
結論:
- 農村部における社会的リスク因子の高い流行は,主に社会経済的地位 (SES) によって説明される.
- HOUSES指数は,プライマリケアにおけるリスクの高い患者を特定するための貴重なツールです.
- この集団における社会的リスクの主要な原動力は,SESではなく,農村です.
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