低收入母亲的社会福利支付和急性伤害。

Open medicine : a peer-reviewed, independent, open-access journal Pub Date : 2012-07-31 Print Date: 2012-01-01
Donald A Redelmeier, William K Chan, Sendhil Mullainathan, Eldar Shafir
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引用次数: 0

摘要

背景:由于危险行为造成的人为错误是与贫困有关的急性伤害的常见和重要因素。我们研究了社会福利支付是否会减轻或加剧导致有受抚养子女的低收入母亲因急性损伤而紧急就诊的危险行为。方法:我们分析了安大略省急诊科的总就诊人数,以确定年龄在15至55岁之间的妇女,她们是18岁以下儿童的母亲,她们生活在社会经济最低的五分之一,并出现急性损伤。我们使用全民医疗保健数据库来评估在社会福利金支付的特定日期(儿童福利金分配)与在7年间隔(2003年4月1日至2010年3月31日)的对照日的急诊科就诊情况。结果:153 377例急诊科就诊符合纳入标准。我们观察到,儿童福利金发放日每天的紧急情况比对照日少(56.4 vs 60.1, p = 0.008)。差异的主要原因是年龄在35岁或以下的母亲(相对减少7.29%,95%可信区间[CI] 1.69%至12.88%)、生活在城市地区的母亲(相对减少7.07%,95%可信区间[CI] 3.05%至11.10%)和在社区医院接受治疗的母亲(相对减少6.83%,95%可信区间[CI] 2.46%至11.19%)的数值较低。在领取儿童福利金之前或之后的7天内,没有观察到显著差异。解释:与政治评论相反,我们发现相对贫困的小幅减少减轻了而不是加剧了导致有受抚养子女的低收入母亲急性伤害的危险行为。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Social benefit payments and acute injury among low-income mothers.

Background: Human error due to risky behaviour is a common and important contributor to acute injury related to poverty. We studied whether social benefit payments mitigate or exacerbate risky behaviours that lead to emergency visits for acute injury among low-income mothers with dependent children.

Methods: We analyzed total emergency department visits throughout Ontario to identify women between 15 and 55 years of age who were mothers of children younger than 18 years, who were living in the lowest socio-economic quintile and who presented with acute injury. We used universal health care databases to evaluate emergency department visits during specific days on which social benefit payments were made (child benefit distribution) relative to visits on control days over a 7-year interval (1 April 2003 to 31 March 2010).

Results: A total of 153 377 emergency department visits met the inclusion criteria. We observed fewer emergencies per day on child benefit payment days than on control days (56.4 v. 60.1, p = 0.008). The difference was primarily explained by lower values among mothers age 35 years or younger (relative reduction 7.29%, 95% confidence interval [CI] 1.69% to 12.88%), those living in urban areas (relative reduction 7.07%, 95% CI 3.05% to 11.10%) and those treated at community hospitals (relative reduction 6.83%, 95% CI 2.46% to 11.19%). No significant differences were observed for the 7 days immediately before or the 7 days immediately after the child benefit payment.

Interpretation: Contrary to political commentary, we found that small reductions in relative poverty mitigated, rather than exacerbated, risky behaviours that contribute to acute injury among low-income mothers with dependent children.

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