Access to hospital care, clinical stage and survival from colorectal cancer according to socio-economic status
Access to hospital care, clinical stage and survival from colorectal cancer according to socio-economic status
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DOI：
10.1023/a:1008352119907
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发表时间：
2000-09-01
影响因子：
50.5
通讯作者：
Vineis, P
中科院分区：
文献类型：
--
作者：
Ciccone, G;Prastaro, C;Vineis, P
低社会经济地位（SES）可能是延迟诊断和延迟入院的一个决定因素，也是延长住院时间的一个因素。社会阶层差异的这些后果可能导致医疗保健效力的不平等和成本的增加[2-4]。几项研究表明，生存与SES有关。不同部位的癌症患者如果属于较低的社会经济地位，则生存率较低[5-8]。然而，根据SES，很少有论文考虑到患者的临床病史（包括入院治疗的时间）和他们的生存。我们在我们的医院进行了一项关于结肠直肠癌的研究，这是一个500万居民地区最大的医院（1800张床位）。在这一地区，绝大多数住院病人都是在国家保健服务体系内就诊的，即一个公共和免费的结构。本研究的目的是调查晚期疾病患者入院的社会和临床决定因素，并评估其对预后的影响。特别是，我们想要确定在公共卫生服务的背景下，社会经济地位是否会影响诊断阶段、医院护理的及时性、住院时间和长期预后bbb。
A low socio-economic status (SES) may be a determinant of delayed diagnosis and delayed access to the hospital, and also of prolonged length of stay [1]. These consequences of social class disparities could entail both inequalities in effectiveness of health care and increased costs [2-4].Survival has been reported to be associated with SES in several studies. Patients with cancer at different sites had lower survival if they belonged to a lower SES [5-8]. However, few papers have considered both the clinical history of the patients (including time to admission to care) and their survival, according to SES. We have conducted a study on colorectal cancer in our hospital, which is the largest (1800 beds) in a region of five million inhabitants. In this region, the vast majority of hospital admissions are within the National Health Service, ie, a public and free-of-charge structure. Purposes of the study were to investigate social and clinical determinants of admissions with advanced disease, and to evaluate their consequences on prognosis. In particular, we wanted to ascertain whether in the context of a public health service, socio-economic status could influence stage of diagnosis, timeliness of hospital care, duration of hospital stay, and long-term prognosis [9].