Effect of socioeconomic status on mortality and care provision among critically ill adult patients
Notice bibliographique
Résumé
Background: Socioeconomic status (SES) has been recognized as an important determinant of health outcomes and healthcare utilization across a variety of chronic and infectious diseases in Canada and internationally. However, the effect of SES on mortality and care provision among critically ill patients has been little investigated. Most importantly, no Canadian study has been completed to date to investigate the distribution and effects of SES in the critically ill. Broadly, the objectives of this study were to investigate whether differences exist in mortality and care provision by SES among adult critically ill patients in a Canadian health region. Methods: This was a population-based retrospective cohort study of patients admitted to intensive care (ICU) in the Calgary Health Region (CHR) between January 2002 and December 2006. The primary outcome measures were hospital and I-year mortality. Median household income, obtained from the 2001 Canadian census, was the primary exposure variable. Receipt of welfare or healthcare premium subsidy and Aboriginal status were the secondary exposure measures. The eventual study sample consisted of 6,822 critically ill CHR residents. ICU and hospital clinical data were linked with the primary exposure data using the Postal Code Conversion File, available from Statistics Canada through the Academic Data Centre at the University of Calgary. Clinical data were linked with secondary exposure data through the CHR population registry file. Descriptive and adjusted analyses of mortality, access to care and intensity of care was undertaken by median household income, welfare/subsidy receipt and Aboriginal status. Results: This study demonstrated a lack of association between SES and hospital mortality or mortality up to 1-year after critical illness. Further, low income, defined by receipt of welfare/subsidy, and Aboriginal status was not associated with increased mortality among critically ill patients. Importantly, these data also show that lower SES is associated with greater use of/access to critical care services; however no differences in intensity of care in ICU or hospital existed by SES. Discussion: The results of this study provide reassurance that hospital and 1-year outcomes after critical illness in the CHR do not differ by SES and highlight the increased need for critical care among individuals oflower SES. Further research is required to investigate whether longer-term outcomes are influenced by SES and to examine the exact nature of the relationship between SES and incidence of critical illness. These results have implications for ICU clinicians interested in optimizing long-term outcomes and for health policy makers interested in evidence-based resource allocation.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».