2004-2017年瑞典人口的死亡率与医疗保健利用的收入差异:一项全国性的注册研究
Pär Flodin1, Peter Allebeck1, Ester Gubi1
1Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
PLoS medicine
|November 16, 2023
概括
医疗保健利用率 (HCU) 的不平等仍然存在,低收入群体使用更多的住院护理,并面临更高的死亡率. 在高收入群体中,初级和专业门诊护理的使用更多地增加,随着时间的推移,健康差异越来越大.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 卫生社会学 卫生社会学
背景情况:
- 尽管有普遍的医疗保健,但医疗保健利用率 (HCU) 的社会经济差异仍然存在.
- 对于HCU不平等的时间趋势的理解有限.
研究的目的:
- 评估最低 (Q1) 和最高 (Q5) 收入量之间的HCU差异的时间趋势.
- 为了将这些HCU趋势与死亡率模式进行比较.
主要方法:
- 在瑞典 (2004-2017年) 进行了基于注册的重复横截面研究设计.
- 关于初级,专科门诊和住院护理利用率以及死亡原因的链接数据.
- 比较Q1和Q5的HCU和死亡率,调整社会人口统计因素. 使用后勤和负二项式回归分析趋势.
主要成果:
- 2017年,Q1利用了更多的住院护理 (OR 1.44) 和比Q5.5有更高的死亡率 (OR 1.78).
- 每年,初级和专业门诊护理的利用率在第五季度比第一季度更多.
- HCU的不平等比死亡率的不平等要小,这种差距随着时间的推移而扩大.
结论:
- 在初级和专科门诊护理利用方面,与收入相关的差异小于死亡率差异,并且正在扩大.
- 在低收入群体中增加初级和门诊护理的动机使用的干预措施可能会减少日益增长的健康不平等.
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