在日本的成年工作者中,收入水平和功能受损
Nana Ishimura1, Kosuke Inoue1,2, Shiko Maruyama3
1Department of Social Epidemiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
JAMA health forum
|March 1, 2024
概括
即使有全民医疗覆盖,低收入也与快速慢性病 (CKD) 进展和置换治疗的更高风险有关. 这凸显了针对收入量身定制的CKD策略的必要性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 慢性病 (CKD) 影响全球8.5亿人,社会经济地位 (SES) 是已知的危险因素.
- 关于在日本等全民医疗覆盖系统中CKD的SES差异的数据有限.
研究的目的:
- 调查收入差异与日本劳动人口中功能障碍的发展之间的联系.
- 根据收入水平,确定快速慢性病进展和替代疗法启动的风险.
主要方法:
- 全国范围内对5,591,060名日本健康保险协会 (2015-2022) 保险的成年人 (34-74岁) 进行了回顾性队列研究.
- 根据2015年收入分数,分析估计的膜过率 (eGFR) 降低和脏替代疗法启动情况.
- 调整了包括性别,年龄和糖尿病状况在内的混因素.
主要成果:
- 最低收入分位数显示,与最高收入分位数相比,慢性脏病的快速进展风险 (aOR,1.70) 和脏替代疗法启动风险 (aHR,1.65) 显著更高.
- 这种基于收入的差异在男性和没有糖尿病的个人中更为明显.
- 在所有CKD阶段 (1-5) 观察到这种关联.
结论:
- 即使在拥有全民医疗覆盖的国家,CKD进展和治疗开始的收入差异仍然存在.
- 调查结果强调,必须根据个人的社会经济地位量身定制CKD预防和管理策略.
- 解决与收入相关的不平等问题对于全球有效的CKD护理至关重要.
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