Small-area variation in hospital discharge rates. Do socioeconomic variables matter?
Small-area variation in hospital discharge rates. Do socioeconomic variables matter?
复制标题
出院率存在小区域差异。
DOI：
10.1097/00005650-198905000-00006
复制
发表时间：
1989
期刊：
影响因子：
3
通讯作者：
Griffith,JR
中科院分区：
文献类型：
--
作者：
McLaughlin,CG;Normolle,DP;Wolfe,RA;McMahonJr,LF;Griffith,JR
尽管对医院出院率变化的决定因素进行了大量研究，但对于社会经济因素的作用仍存在分歧。缺乏共识的部分原因是，在使用不同分析单位和方法的研究中，很难比较结果。许多使用明确界定的医院服务领域的研究没有对医院利用的决定因素进行控制分析所需的数据。大多数进行对照分析的研究都依赖于更大的地缘政治区域，而这些区域据信不能涵盖自给自足的医疗保健系统。这里描述的这项研究使用了一组一致的数据、三种分析方法和两个分析单位来测试社会经济特征在解释密歇根州医疗和手术出院率变化方面的重要性。无论分析方法是简单相关还是多元回归，以及分析单位是县还是设计良好的医院服务区，社会经济因素都被发现是医疗和手术出院率差异的统计显著决定因素。这些结果表明，以前的小区域差异研究可能错误地得出结论，认为社会经济特征不能解释利用率的差异。
Although numerous studies have been made of the determinants of smallarea variation in hospital discharge rates, there is still disagreement about the role of socioeconomic factors. The lack of consensus stems, in part, from the difficulty in comparing results across studies that use different units and methods of analysis. Many of the studies using well-defined hospital service areas did not have the data needed to conduct a controlled analysis of the determinants of hospital utilization. Most of the studies that have performed controlled analyses have relied on larger geopolitical areas, which are not believed to capture self-contained health care systems. The study described here used a consistent set of data, three methods of analysis, and two units of analysis to test the importance of socioeconomic characteristics in explaining the variation in medical and surgical discharge rates in Michigan. Socioeconomic factors are found to be statistically significant determinants of the variation in both medical and surgical discharge rates, whether the method of analysis is simple correlations or multiple regressions, and whether the unit of analysis is the county or a well-designed hospital service area. These results suggest that previous small-area variation studies may have incorrectly concluded that socioeconomic characteristics do not explain differences in utilization rates.