Socio-economic determinants of casualty and NHS Direct use
Socio-economic determinants of casualty and NHS Direct use
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DOI：
10.1093/pubmed/fdn001
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发表时间：
2008-03-01
影响因子：
4.4
通讯作者：
Cook, D. G.
中科院分区：
文献类型：
--
作者：
Shah, S. M.;Cook, D. G.
背景有有限的证据对社会的决定因素的A&E使用和NHS Direct utilization.Methods的公平问题，我们分析了2004-05年英国综合住户调查，其中包括20 421名参与者的数据。Logistic回归是用来检查个人伤亡使用在过去的3个月和家庭NHS直接使用在过去的year.Results伤亡使用较高的个人生活在租来的住宿或没有汽车访问，低收入群体，非熟练的体力劳动者，目前吸烟者和限制疾病的个人。相比之下，在居民年龄较大、收入较低、没有汽车以及户主来自体力职业群体、少数民族群体或出生在英国境外的家庭中，NHS直接使用率较低。最低等值收入五分位数家庭使用NHS Direct的比值比为0.67（0.55-0.81）。限制疾病的调整增加了NHS Direct use.Conclusions的社会经济因素的影响减少获得A&E服务将不成比例地影响贫困的个人，而增加对电话服务的投资将有利于富裕的人群。目前的国家政策可能会扩大获得紧急护理方面的不平等。
Background There is limited evidence on the social determinants of A&E use and concerns over the equity of NHS Direct utilization.Methods We analysed data from the 2004-05 British General Household Survey, which included 20 421 participants. Logistic regression was used to examine individual casualty use in the last 3 months and household NHS Direct use in the last year.Results Casualty use was higher for individuals living in rented accommodation or without car access, lower income groups, unskilled manual workers, current smokers and for individuals with limiting illness. In contrast, NHS Direct use was lower in households with older residents, low income, no car access and where the head of household was from a manual occupational group, a minority ethnic group or born outside the UK. The odds ratio for use of NHS Direct for households in the lowest equivalized income quintile was 0.67 (0.55-0.81). Adjustment for limiting illness increased the effect of socio-economic factors on NHS Direct use.Conclusions Reduced access to A&E services will disproportionately affect poorer individuals, whereas increased investment in telephone services will benefit affluent populations. Current national policy may widen inequities in access to emergency care.