Measuring the need for primary health care: an index of relative disadvantage
Measuring the need for primary health care: an index of relative disadvantage
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DOI：
10.1016/s0143-6228(00)00015-1
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发表时间：
2000-10-01
影响因子：
4.9
通讯作者：
Field, K
中科院分区：
文献类型：
--
作者：
Field, K
提供初级保健的主要目标是保持或改善人口的健康。资源的公平分配对此至关重要，并采取了不利措施，以评估不同的需求水平，作为根据全科医生的工作量计算剥夺补助金的基础。尽管研究强调了衡量社会劣势的好处，但指数尚未用于从根本上确定卫生当局的资源分配。本文利用病人利用行为调查的结果，根据相对需要和可及性的组成部分，定义和建模的决定因素，卫生保健的需要，代理指标推导出前常规数据来源，以创建一个相对劣势指数（IRD）。敏感性分析证实了该指数的鲁棒性，并表明，虽然该指数采用了更广泛的变量比以前大多数剥夺指数，有没有毛数据冗余。简化版本的索引也进行了探索和评估。在此制定的IRD与其他不利指数密切相关，但其更大的广度和更合理的结构意味着它可能更有可能成为一个更广泛适用于卫生和资源分配规划的工具。(C)2000爱思唯尔科技有限公司版权所有。
The prime objective of primary health care provision is the maintenance or improvement of the population's health. The equitable distribution of resources is paramount to this and measures of disadvantage are implemented to assess differential levels of need as a basis for calculating deprivation payments according to general practitioner workload. Despite research that highlights the benefits of measures of social disadvantage, indices have not been used to fundamentally shape resource allocation for health authorities. This paper uses the results from a patient survey into utilization behaviour to define and model the determinants of the need for health care based on components of relative need and accessibility, Proxy indicators are derived front routine sources of data to create an Index of Relative Disadvantage (IRD). A sensitivity analysis confirms the robustness of the index and shows that-although the index employs a wider range of variables than most previous deprivation indices-there is no gross data redundancy. Simplified versions of the index are also explored and evaluated. The IRD developed here is closely correlated with other indices of disadvantage, but its greater breadth and more logical construction mean that it may be more likely to be a more widely applicable instrument for health came planning of resource allocation. (C) 2000 Elsevier Science Ltd. All rights reserved.