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在老年人中,生命末期症状负担的财富差异
Irena Cenzer1, Kenneth E Covinsky1,2, Sarah H Cross3
1Division of Geriatrics, University of California, San Francisco.
JAMA network open
|March 6, 2025
概括
较低的财富与生命末期症状负担的增加有关,由多病症和功能障碍驱动. 解决财富差距对于改善息治疗和患者体验至关重要.
科学领域:
- 老年学是指老年学的学科.
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
背景情况:
- 了解终身护理的社会经济决定因素对于公平的患者结果至关重要.
- 财富,与收入不同,显著影响健康轨迹和经验.
研究的目的:
- 调查不同财富类别中12种生命终结症状的流行情况.
- 分析财富和高症状负担之间的关联,以及多病症,功能障碍和痴呆症等潜在的调解者.
主要方法:
- 利用了来自健康和退休研究 (HRS) 的数据,这是美国老年人的全国代表性队列 (N=8976名死者).
- 雇佣了修改后的波桑回归来评估症状的流行程度和负担,调整了许多人口和社会经济因素.
- 根据资产对财富进行了分类,分为低,中,高四分位数.
主要成果:
- 较低的财富与更高的临终症状患病率有关,并显著增加了高症状负担的风险.
- 与中等 (28.0%) 和高财富 (23.2%) 组相比,低财富组 (37.0%) 的高症状负担最为普遍.
- 多种疾病,功能障碍和痴呆症在较低财富的人群中更为常见,并充当了重要的调解者,功能障碍是最强的.
结论:
- 较低的财富是生命结束时增加症状负担的重要预测因素.
- 调查结果强调需要有针对性的政策和干预措施,以支持经济不利的老年人,并减少终身护理差异.
- 解决医疗保健中与财富相关的不平等问题对于改善临近生命终点的所有人的生活质量至关重要.
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