Socioeconomic deprivation and the clinical management of self-harm: a small area analysis.
Socioeconomic deprivation and the clinical management of self-harm: a small area analysis.
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DOI：
10.1007/s00127-017-1438-1
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发表时间：
2017-12
影响因子：
4.4
通讯作者：
Gunnell D
中科院分区：
文献类型：
--
作者：
Carroll R;Knipe D;Moran P;Gunnell D
社会经济剥夺与自我伤害率的增加有关，但其与临床护理水平的关系以前没有被探讨过。本研究的目的是调查社会经济差异的人谁自残的临床管理。对3607名在自残后到市中心一家大型医院就诊的人的横断面分析。生活在最贫困的五分之一人口中的人更有可能接受心理社会评估（最贫困者对最贫困者：63.51%对70.14%）。这种效应在我们的完全调整模型中持续存在（OR 1.45，CI 1.15-1.82，p = 0.002）。中介分析表明，这种关联在很大程度上是由来自更高贫困地区的人的自我放电率更高来解释的。与来自较贫困地区的人相比，来自较贫困地区的人在自残后到医院就诊时更有可能接受心理社会评估。来自贫困地区的人从急诊室自行出院的比例较高，这可能解释了这种联系。本文的在线版本（doi：10.1007/s 00127 -017-1438-1）包含补充材料，可供授权用户使用。
Socioeconomic deprivation is associated with increased rates of self-harm but its association with levels of clinical care has not previously been explored. The aim of the current study was to investigate socioeconomic differences in the clinical management of people who self-harm. Cross-sectional analysis of 3607 people presenting to a large inner-city hospital following self-harm. People living in the least deprived quintile were more likely to receive a psychosocial assessment (most vs. least deprived: 63.51 vs. 70.14%). This effect persisted in our fully adjusted model (OR 1.45, CI 1.15–1.82, p = 0.002). Mediation analysis suggested this association was in large part explained by higher rates of self-discharge in people presenting from areas of higher deprivation. Compared to those from more deprived areas, people from less deprived areas are more likely to receive a psychosocial assessment when presenting to hospital following self-harm. The occurrence of higher rates of self-discharge from emergency departments among those from more deprived areas may explain the association. The online version of this article (doi:10.1007/s00127-017-1438-1) contains supplementary material, which is available to authorized users.
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