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背景过去十年,糖尿病病人的死亡率显著下降。但尚不了解所有收入组获益是否均等。我们调查了收入对糖尿病病人死亡趋势的影响。方法基于这个人群,回顾定群研究,1994年4月1日—2005年3月31日,根据地区收入分层,对加拿大安大略省年龄≥30岁的糖尿病病人的死亡率变化做了对照。结果总体,年龄和性别校正后,年度死亡率从1994/1995年的4.05%[95%CI(3.98%,4.11%)]降至2005/2006年的2.69%[95%CI(2.66%,2.73%)]。与最低收入组(31%,P<0.001)比较,最高收入组死亡率下降幅度明显要大(36%)。这种趋势在年龄较轻组(30~64岁)最为突出:最低与最高收入组的死亡比率加大>40%,女性为1.12~1.59,男性为1.14~1.60。收入对年长组死亡率趋势的影响要小得多,他们的药费有补助金:本研究期间与收入相关差异仅上升为0.9%。解释1994—2005年糖尿病病人总体死亡率呈下降趋势;然而最高收入组比最低收入组下降的幅度要大,尤其是年龄30~64岁者。这些发现说明,即便在公费医疗机构,收入对糖尿病者的健康影响呈增长趋势。为了澄清这些与收入相关的死亡率差异因素,还需做进一步研究。
Background Over the past decade, the mortality rate of diabetic patients has dropped significantly. However, it is unclear whether all income groups benefit equally. We investigated the impact of income on death trends in diabetic patients. Methods Based on this population, review the cohort study and compare changes in mortality among diabetic patients ≥30 years of age in Ontario, Canada, from April 1, 1994 to March 31, 2005, based on regional income stratification. Results Overall, age and gender-adjusted annual mortality fell from 4.05% [95% CI (3.98%, 4.11%)] in 1994/1995 to 2.69% [95% CI (2.66%, 2.73 %)]. Compared with the lowest income group (31%, P <0.001), the mortality rate in the highest income group was significantly lower (36%). This trend was most pronounced in the younger age group (30-64 years): the death rate in the lowest and highest income groups increased by> 40%, in women from 1.12 to 1.59 and in men from 1.14 to 1.60. Revenue has a much smaller effect on the trend of older group mortality with subsidies for their medicines: Income-related differences rose only to 0.9% over the study period. Explain that the overall mortality rate of diabetic patients decreased from 1994 to 2005; however, the highest income group dropped more than the lowest income group, especially those aged 30-64 years. These findings show that, even in public health institutions, the health effects of income on people with diabetes are on the rise. To clarify these income-related mortality differences, further research is needed.