The effect of socioeconomic status on bone density testing in a public health-care system
The effect of socioeconomic status on bone density testing in a public health-care system
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DOI：
10.1007/s00198-006-0212-0
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发表时间：
2007-02-01
影响因子：
4
通讯作者：
Reed, M.
中科院分区：
文献类型：
--
作者：
Demeter, S.;Leslie, W. D.;Reed, M.
简介和假设 社会经济地位（SES）与骨质疏松性骨折之间存在反比关系。在公共资助的医疗保健系统中，进行骨矿物质密度（BMD）测试不应存在任何障碍，特别是对于那些骨折风险较高的人来说。我们的假设是，SES 和 BMD 利用率之间存在正相关关系（即高收入女性的利用率较高），从而导致对社会经济地位较低或收入较低的女性不利的差异。 方法 利用马尼托巴骨密度计划的基于人口的 BMD 数据库来评估 50 岁及以上女性 (n=107,944) 的 SES（使用收入五分位数定义）和 BMD 利用率之间的关联。 2001-2002 财政年度。按年龄（50-64 岁和 65 岁或以上）和从约翰·霍普金斯大学调整临床组病例组合调整系统获得的发病指数对分析进行分层。结果回归模型显示，在所有年龄和发病层中，高 SES 女性的 BMD 利用率均显着较高。 50 至 64 岁女性的比率为 1.76（95% CI：1.52-2.04），65 岁或以上低发病率女性的比率为 2.36（95% CI：1.60-3.49）。 结论 在公共资助的医疗保健系统中，SES 和 BMD 使用率之间存在显着的负相关关系。需要进一步的研究来更好地了解这些关联的性质以及它们如何对健康结果做出贡献。
Introduction and hypothesis An inverse relationship exists between socio-economic status (SES) and osteoporotic fractures. In publicly funded health-care systems there should be no barriers to accessing bone mineral density (BMD) testing, especially for those at increased fracture risk. Our hypothesis was that there would be a positive association between SES and BMD utilization (i.e. higher utilization rates in higher income women), resulting in disparities that disadvantage lower SES or lower income women.Methods A population-based BMD database from the Manitoba Bone Density Program was utilized to assess the association between SES (defined using income quintiles) and BMD utilization rates in women aged 50 years and older (n=107,944) for the 2001-2002 fiscal year. Analyses were stratified by age (50-64 years old and 65 years or older) and by a morbidity index obtained from the Johns Hopkins University Adjusted Clinical Group Case-Mix Adjustment System.Results Regression models demonstrated significantly higher BMD utilization rates among high SES women in all age and morbidity strata. Rate ratios varied from 1.76 (95% CI: 1.52-2.04) in 50- to 64-year-old women to 2.36 (95% CI: 1.60-3.49) in low morbidity women aged 65 or older.Conclusions Within the context of a publicly funded health-care system significant inverse associations are demonstrated between SES and BMD utilization rates. Further research is needed to better understand the nature of these associations and how they may contribute to health outcomes.