Socioeconomic Inequalities in Risk of Hospitalization for Community-Acquired Bacteremia: A Danish Population-Based Case-Control Study
Socioeconomic Inequalities in Risk of Hospitalization for Community-Acquired Bacteremia: A Danish Population-Based Case-Control Study
复制标题
DOI：
10.1093/aje/kwu032
复制
发表时间：
2014-05-01
影响因子：
5
通讯作者：
Schonheyder, Henrik Carl
中科院分区：
文献类型：
--
作者：
Koch, Kristoffer;Sogaard, Mette;Schonheyder, Henrik Carl
在丹麦的一项基于人群的病例对照研究中，我们研究了社会经济地位（SES）与社区获得性菌血症风险之间的关联，以及慢性病和药物滥用对菌血症风险差异的影响。分析基于 2000 年至 2008 年期间首次因社区获得性菌血症住院的 4,117 名 30-65 岁患者以及按性别、年龄和居住地区匹配的 41,170 名对照人群。有关 SES（教育和收入）、慢性病和药物滥用的个人信息是从公共和医疗登记处检索的。使用条件逻辑回归来计算菌血症的比值比。低社会经济地位的人比高社会经济地位的人患菌血症的风险要高得多（对于短期教育与长期教育，优势比 = 2.30（95% 置信区间：2.10, 2.52）；对于低收入与高收入，优势比 = 2.77（95% 置信区间：2.54, 3.02））。低 SES 个体与高 SES 个体相比，慢性病和药物滥用的患病率较高，这解释了菌血症风险的社会经济差异的 43%-48%。在一个拥有全民福利体系的国家，慢性病负担和药物滥用的差异似乎对于解释菌血症风险的不平等具有重要意义。
In a Danish population-based case-control study, we examined the association between socioeconomic status (SES) and risk of community-acquired bacteremia, as well as the contribution of chronic diseases and substance abuse to differences in bacteremia risk. Analyses were based on 4,117 patients aged 30-65 years who were hospitalized with first-time community-acquired bacteremia during 2000-2008 and 41,170 population controls matched by sex, age, and region of residence. Individual-level information on SES (education and income), chronic diseases, and substance abuse was retrieved from public and medical registries. Conditional logistic regression was used to compute odds ratios for bacteremia. Persons of low SES had a substantially higher risk of bacteremia than those of high SES (for short duration of education vs. long duration, odds ratio = 2.30 (95% confidence interval: 2.10, 2.52); for low income vs. high income, odds ratio = 2.77 (95% confidence interval: 2.54, 3.02)). A higher prevalence of chronic diseases and substance abuse in low-SES individuals versus high-SES individuals explained 43%-48% of the socioeconomic differences in bacteremia risk. In a country with a universal welfare system, differences in the burden of chronic diseases and substance abuse seem to have major importance in explaining inequalities in bacteremia risk.