使用个人社会经济地位指数分析结肠直肠癌查中的不平等情况
Paula Romeo-Cervera1, Javier Martín-Pozuelo2, Mercedes Vanaclocha-Espí1
1Foundation for the Promotion of Health and Biomedical Research (FISABIO), 46020 Valencia, Spain.
Cancers
|December 17, 2024
概括
社会经济地位显著影响着结肠直肠癌查参与和结肠镜接受. 较低社会经济群体的参与率较低,但结肠镜接受率较高,表明复杂的健康公平挑战.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 结肠直肠癌查计划的目标是公平参与.
- 社会经济地位 (SES) 是健康差异的一个已知的决定因素.
- 了解与SES相关的查不平等对于计划改进至关重要.
研究的目的:
- 在瓦伦西亚地区结肠直肠癌查计划 (VR-CRCSP) 中分析参与和结肠镜接受的社会经济不平等.
- 确定与查差异相关的特定社会经济因素.
主要方法:
- 在50-69岁的1,066,763名受邀参加VR-CRCSP的个人中进行了横截面研究.
- 开发一个个人社会经济地位指数 (ISESI),使用国籍,就业,残疾,医疗覆盖,脆弱性风险和家庭规模.
- 混合后勤回归模型用于估计SES四分位数中参与和结肠镜验收的几率比率 (ORs) 和95%置信区间 (CI).
主要成果:
- 低SES四分位数 (Q2,Q3) 的个人比最高SES (Q1) 的参与率更高,而最低SES (Q4) 的参与率更低.
- 所有较低的SES四分位数 (Q2,Q3,Q4) 与最高的SES四分位数 (Q1) 相比,结肠镜验收的可能性显著更高.
- 非西班牙国籍,残疾,没有家庭单位,社会脆弱性风险和私人医疗保险与不参加和拒绝结肠镜有关.
结论:
- 在VR-CRCSP的参与和结肠镜验收方面存在重大社会经济不平等.
- 需要有针对性的干预措施来解决影响查行为的SES因素的复杂相互作用.
- 进一步的研究应该探索在较低的SES群体中接受更高的结肠镜的原因,尽管存在参与障碍.
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