{"id":244,"date":"2013-07-26T14:04:03","date_gmt":"2013-07-26T05:04:03","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=244"},"modified":"2015-08-06T14:06:30","modified_gmt":"2015-08-06T05:06:30","slug":"%e3%83%97%e3%83%a9%e3%82%a4%e3%83%9e%e3%83%aa%e3%83%bb%e3%82%b1%e3%82%a2%e5%8c%bb%e3%81%ae%e4%be%9b%e7%b5%a6%e3%81%a8%e6%ad%bb%e4%ba%a1%e7%8e%87%e3%80%80%e2%80%90%e5%8f%8e%e5%85%a5%e3%82%84%e4%ba%ba","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=244","title":{"rendered":"\u30d7\u30e9\u30a4\u30de\u30ea\u30fb\u30b1\u30a2\u533b\u306e\u4f9b\u7d66\u3068\u6b7b\u4ea1\u7387\u3000\u2010\u53ce\u5165\u3084\u4eba\u7a2e\u306e\u89b3\u70b9\u304b\u3089\u2010"},"content":{"rendered":"

– \u6587\u732e\u540d –<\/p>\n

Shi L, Starfield B. The effect of primary care physician supply and
\nincome inequality on mortality among blacks and whites in US metropolitan
\nareas. Am J Public Health. 2001
\nAug;91(8):1246-50.<\/p>\n

– \u3053\u306e\u6587\u732e\u3092\u9078\u3093\u3060\u80cc\u666f –<\/p>\n

\u3000In terms of medical policies, how access to care
\ninfluence population health is a relevant issue. My clinical question is “primary
\ncare physician improve population health ? “. I searched for the evidence and
\npicked this article out for today’s discussion.<\/p>\n

– \u8981\u7d04\u00a0–<\/p>\n

Objectives:<\/p>\n

This study assessed whether income inequality and primary care physician supply have a different effect on mortality among Blacks compared with Whites.
\n\u00a0
\nMethods:
\nWe conducted a multivariate ecologic analysis of 1990 data from 273 US metropolitan areas.
\n\u00a0
\nResults:
\nBoth income inequality and primary care physician supply were significantly associated with White mortality (P < .01).After the inclusion of the socioeconomic status covariates, the effect of income inequality on Black mortality remained significant (P < .01), but the effect of primary care physician supply was no longer significant (P > .10), particularly in areas with high income inequality.
\n\u00a0
\nConclusions.
\nImprovement in population health requires addressing\u2028socioeconomic determinants of health, including income inequality and primary\u2028care availability and access.<\/p>\n

\u2193\u3000\u753b\u50cf\u3092\u30af\u30ea\u30c3\u30af\u3059\u308b\u3068\u5168\u4f53\u304c\u8868\u793a\u3055\u308c\u307e\u3059\u3002
\n\"130726_1\"<\/a><\/p>\n

\u2193\u3000\u753b\u50cf\u3092\u30af\u30ea\u30c3\u30af\u3059\u308b\u3068\u5168\u4f53\u304c\u8868\u793a\u3055\u308c\u307e\u3059\u3002
\n\"130726_2\"<\/a><\/p>\n

\u2193\u3000\u753b\u50cf\u3092\u30af\u30ea\u30c3\u30af\u3059\u308b\u3068\u5168\u4f53\u304c\u8868\u793a\u3055\u308c\u307e\u3059\u3002
\n\"130726_3\"<\/a><\/p>\n

– \u8003\u5bdf\u3068\u30c7\u30a3\u30b9\u30ab\u30c3\u30b7\u30e7\u30f3 –<\/p>\n

\u3000An econometric analysis has some weak points. First, omitted-variable bias is likely to occur because a dependent variable is influenced by numerous factors in social environment. Omitted-variable bias occurs when a model is created which incorrectly leaves out one or more important causal factors. Second, accurate regulations of confounding factors are usually difficult because of high complexity. But what is important is doing with the best knowledge available at the time. Policy should be done promptly and then checked whether it is effective or not. Social medicine needs a capability to evaluate policy which is ever adopted.\u3000<\/p>\n

\u958b\u50ac\u65e5\uff1a\u5e73\u621025\u5e747\u670817\u65e5<\/p>\n","protected":false},"excerpt":{"rendered":"

– \u6587\u732e\u540d – Shi L, Starfield B. The effect of primary care physician supply and income inequality on m … \u7d9a\u304d\u3092\u8aad\u3080 \u30d7\u30e9\u30a4\u30de\u30ea\u30fb\u30b1\u30a2\u533b\u306e\u4f9b\u7d66\u3068\u6b7b\u4ea1\u7387\u3000\u2010\u53ce\u5165\u3084\u4eba\u7a2e\u306e\u89b3\u70b9\u304b\u3089\u2010<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[23],"tags":[],"class_list":["post-244","post","type-post","status-publish","format-standard","hentry","category-23"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/244","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=244"}],"version-history":[{"count":3,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/244\/revisions"}],"predecessor-version":[{"id":250,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/244\/revisions\/250"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=244"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=244"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=244"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}