以人口为基础的新西兰儿童队列的居住流动性和潜在可避免的住院

Kim Nathan, O. Robertson, Polly Atatoa Carr, P. Howden-Chapman, N. Pierse
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引用次数: 2

摘要

背景:居住迁移在儿童早期很常见,并且已经发现居住迁移与儿童不良健康和福祉结果之间存在关联。虽然有关于儿童潜在可避免住院(PAH)的研究,但很少有人研究PAH与居住流动性的关系。因此,我们的目的是调查以人口为基础的新西兰儿童队列的居住流动性和多环芳烃。方法采用回顾性队列设计,我们分析了来自综合数据基础设施的314283名自2004年初以来出生的儿童的数据,这些儿童在2岁之前至少有一个居住地址。居住流动性来源于地址数据,多环芳烃来源于出院数据。结果半数队列儿童(52%)在2岁前至少搬过一次家,22%的儿童搬过两次或两次以上家。该队列中15%的人在2至4岁之间经历过一次或多次多环芳烃。研究发现,居住流动性与多环芳烃之间存在线性关联(相对风险(RR)=1.18, CI 1.17至1.19),并且在调整了几个协变量后,这种相关性仍然很强。对门诊敏感住院(ACSH)和多环芳烃归因于住房/物理环境(PAH- he)的敏感性分析得出的结果与多环芳烃非常相似(ACSH:调整RR (aRR)=1.10, CI 1.09至1.11;PAH-HE: aRR=1.11, CI 1.10 ~ 1.12)。结论:本研究发现,较高的居住流动性与幼儿患多环芳烃的可能性增加之间存在线性关联。提出了进一步研究的途径。
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Residential mobility and potentially avoidable hospitalisations in a population-based cohort of New Zealand children
Background Residential moves are common in early childhood and associations have been found between residential mobility and adverse child health and well-being outcomes. Although there are studies on potentially avoidable hospitalisations (PAH) in children, few have examined PAH in relation to residential mobility. Our aim, therefore, was to investigate residential mobility and PAH in a population-based cohort of New Zealand children. Methods Using a retrospective cohort design, we analysed data from the Integrated Data Infrastructure for a cohort of 314 283 children born since the start of 2004, who had at least one residential address recorded by 2 years of age. Residential mobility was derived from address data and PAH were determined from hospital discharge data. Results Half of the cohort children (52%) experienced at least one residential move by 2 years of age, and 22% experienced two or more moves. Fifteen per cent of the cohort experienced one or more PAH between 2 and 4 years of age. A linear association between residential mobility and PAH was found (relative risk (RR)=1.18, CI 1.17 to 1.19) and this remained robust when adjusting for several covariates. Sensitivity analyses for ambulatory care sensitive hospitalisations (ACSH) and PAH attributable to the housing/physical environment (PAH-HE) produced results very similar to those for PAH (ACSH: adjusted RR (aRR)=1.10, CI 1.09 to 1.11; PAH-HE: aRR=1.11, CI 1.10 to 1.12). Conclusion This study found a linear association between higher residential mobility and an increased likelihood of PAH in young children. Avenues for further investigation are suggested.
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