关于人们死亡地点的社会决定因素:对调解员和调解员的研究,使用相关的英国人口普查和死亡率数据
J M Davies1, K C Chua2, M Maddocks1
1Cicely Saunders Institute, Department of Palliative Care, Policy and Rehabilitation, Faculty of Nursing, Midwifery and Palliative Care, King's College London, UK.
SSM - population health
|April 18, 2025
概括
社会经济不平等影响人们死亡的地方,更贫困的个人更有可能在医院死亡. 针对贫困地区独自生活的人提供有针对性的支持,可以减少终身护理方面的差异.
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
- 健康的社会经济决定因素
背景情况:
- 死亡地点对终身护理质量产生重大影响.
- 医院死亡在高收入国家普遍存在,不成比例地影响贫困人口.
- 死亡的社会经济不平等需要检查影响因素.
研究的目的:
- 在死亡的位置调查社会经济不平等.
- 确定这些不平等的调节者和调解者.
- 为减少终身护理机构差异的战略提供信息.
主要方法:
- 利用英格兰和威尔士 (2011-2017) 的相关人口普查和死亡率数据.
- 分析了基于地区的收入剥夺和死亡地点 (医院,家庭,宿舍,养老院) 之间的关联.
- 测试了主持人 (年龄,性别,种族,死亡原因,地区) 和调解人 (住房,独自生活,健康状况).
主要成果:
- 在更贫困地区 (52.4%) 与最贫困地区 (46.7%) 观察到更高的医院死亡比例.
- 死亡原因调节的关联;癌症,痴呆症和"其他"原因明显的社会梯度.
- 孤独生活部分调解了收入剥夺对医院死亡的影响,特别是在癌症患者 (12.2%的总影响).
结论:
- 社会经济地位是死亡地点的重要决定因素,突出了健康不平等.
- 支持在贫困地区独自生活的人的干预措施可能会减轻生命终结地点的差异.
- 调查结果强调,需要公平地获得首选的终身护理机构.
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