Are data on the uptake of disability benefits a useful addition to census data in describing population health care needs?
Are data on the uptake of disability benefits a useful addition to census data in describing population health care needs?
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关于残疾福利领取情况的数据是否可以作为人口普查数据的有用补充来描述人口医疗保健需求？
DOI：
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发表时间：
2004
影响因子：
2.4
通讯作者：
M. Stevenson
中科院分区：
文献类型：
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作者：
D. O’Reilly;M. Stevenson
目的：确定北爱尔兰政府部门掌握的与领取残疾津贴有关的行政数据是否公平、公正地反映了对医疗保健的相对需求，因此是对人口普查数据的有益补充。方法：对北爱尔兰566个选区进行生态研究。利用与健康有关的福利（残疾生活津贴）的差异，对其他三个健康指标（限制长期疾病、死亡率和住院病人人数）进行了回归分析。所有的指标都间接地按年龄和性别进行了标准化。该模型的未标准化残差根据社会和地理因素（即地区剥夺得分、宗教教派组成和城乡居住）进行了回归，以确定它们对福利吸收的影响是否超过与健康状况不健康的任何关联。结果：健康因素单独解释了获益吸收变化的77.2%，限制长期疾病是主要决定因素；然而，即使在控制了健康状况的差异之后，在更多的城市地区和天主教徒比例较大的地区，受益率也较高。一旦控制了健康差异，区域剥夺就与获益吸收无关。结论：关于残疾津贴的行政数据无疑可以为描述地区相对不利或健康状况不佳的程度提供有用的额外信息。然而，由于它们也反映了吸收的变化，这似乎受到社会和地理因素的混淆，我们敦促在使用它们来确定优先领域或分配资源时要谨慎。
Objective: To determine if administrative data relating to the uptake of disability benefits held by government departments in Northern Ireland are fair and unbiased indicators of relative need for health care and therefore a useful addition to census data. Method: This is an ecological study of the 566 electoral wards in Northern Ireland. The variation in uptake of a health-related benefit (Disability Living Allowance) was regressed against three other indicators of health (limiting long-term illness, mortality and the numbers of patients admitted to hospital). All the indicators had been indirectly standardised by age and sex. The unstandardised residuals from this model were regressed against the social and geographical factors, namely area deprivation score, religious denominational composition and urban/rural dwelling to see if they influenced benefit uptake above and beyond any association with ill health. Results: The health factors alone explained 77.2% of the variation in benefit uptake, with limiting long-term illness being the major determinant; however, even after controlling for differences in health status, benefit uptake was shown to be higher in more urban areas and in areas that had a greater proportion of Catholics. Area deprivation was not associated with benefit uptake once health differences had been controlled for. Conclusion: Administrative data on disability benefits can undoubtedly provide useful additional information for describing the levels of relative disadvantage or ill health of areas. However, because they also reflect variations in uptake, which appears to be confounded by social and geographical factors, we would urge caution when they are used to identify priority areas or to allocate resources.