Does the density of the health workforce predict adolescent health? A cross-sectional, multilevel study of 38 countries.
Does the density of the health workforce predict adolescent health? A cross-sectional, multilevel study of 38 countries.
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卫生人员的密度是否可以预测青少年的健康状况？
DOI：
10.1093/pubmed/fdy096
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Elgar,FrankJ
中科院分区：
文献类型：
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作者：
Riehm,KiraE;Latimer,Eric;Quesnel-Vallée,Amélie;Stevens,GonnekeWJM;Gariépy,Geneviève;Elgar,FrankJ
关于卫生专业人员的可获得性与青少年健康之间的关系，以及卫生人力的规模是否对各个社会经济阶层的青少年都同样有利，目前缺乏证据。方法我们对38个国家的青少年健康状况进行了横断面分析。数据来自2013/2014年学龄儿童健康行为调查中的218790名青少年。我们使用多水平回归分析来检验卫生人力密度与心身和精神健康症状之间的关系，并控制了国家财富和收入不平等的差异。结果心理医生密度越大，青少年自我报告的心理健康状况越好（P= 0.047）；然而，这一发现在敏感性分析中并不可靠。医生和精神科医生的密度与更好的青少年心身或心理健康没有显著关联。卫生人力和社会经济地位之间的跨层次互动与健康无关，这表明更多的卫生人力并没有减少青少年健康方面的社会经济差异。结论：本研究发现，在卫生保健提供者密度较高的国家，青少年的身心或精神健康状况并不较好。其他社会或结构因素可能在青少年健康中发挥更大的作用。
BackgroundScant evidence exists on the relation between the availability of health professionals and adolescent health, and whether the size of the health workforce equally benefits adolescents across socioeconomic strata.MethodsWe conducted a cross-sectional analysis of adolescent health in 38 countries. Data from 218 790 adolescents were drawn from the 2013/2014 Health Behavior in School-aged Children survey. We used multilevel regression analyses to examine the association between the density of the health workforce and psychosomatic and mental health symptoms with differences in country wealth and income inequality controlled.ResultsA higher density of psychologists was associated with better self-reported mental health in adolescents (P= 0.047); however, this finding was not robust to sensitivity analyses. The densities of physicians and psychiatrists were not significantly associated with better adolescent psychosomatic or mental health. Cross-level interactions between the health workforce and socioeconomic status did not relate to health, indicating that larger health workforces did not reduce socioeconomic differences in adolescent health.ConclusionsThis study found that adolescents in countries with a higher density of health providers do not report better psychosomatic or mental health. Other social or structural factors may play larger roles in adolescent health.