Background and Purpose:There is evidence of unequal access to health care int erventions even where universal health systems operate. We investigated associat ions between patients’sociodemographic characteristics an...Background and Purpose:There is evidence of unequal access to health care int erventions even where universal health systems operate. We investigated associat ions between patients’sociodemographic characteristics and the provision of acu te and longer-term stroke care in a multiethnic urban population.Methods:We us ed data from 1635 patients with first-ever stroke, collected by a population-b ased stroke register from 1995 to 2000. Using multivariable analyses, controlled for sociodemographic and clinical factors, we investigated access to 22 evidenc e-based components of care. Results:1392 patients(85.1%) were admitted to hos pital; of these, 354 (25.4%) were admitted or transferred to a stroke unit. Of those with clinical need, 607 (70.7%) received physical therapies; 477 (59.8%) received speech and language therapy. Older age was associated with lower odds of hospitalization (odds ratio [OR], 0.50; 95%CI, 0.32 to 0.77, P=0.02) and dia gnostic brain imaging (OR,0.15; 95%CI, 0.08 to 0.30, P < 0.01) but higher odds of receiving physical therapy (OR, 4.24;95%CI, 1.22 to 14.73,P < 0.01).Black et hnicity was associated with higher odds of stroke unit admission (OR, 1.59; 95% CI, 1.01 to 2.49, P < 0.04). There was a weak association between socioeconomic status and admission to hospital and stroke unit. Gender was associated only wit h treatment of hypertension before stroke. Conclusions:Provision of individual components of care over 1 year varied for specific sociodemographic categories, but there was no consistent pattern of in equality. Clinical decision-making pr ocesses are likely to influence these patterns. Further information about clinic ian and patient roles in decision making is required.展开更多
引言1728年,身为克腾侯爵宫廷乐队指挥的巴赫(Johann Sebastian Bach,1685-1750)以《马太福音》基督被捕和受难的情节为文本基础,利用亨利奇的宗教诗文,创作了《马太受难曲》。(1)作品第一次演出就以完败告终,公众领会不到巴赫的音乐所...引言1728年,身为克腾侯爵宫廷乐队指挥的巴赫(Johann Sebastian Bach,1685-1750)以《马太福音》基督被捕和受难的情节为文本基础,利用亨利奇的宗教诗文,创作了《马太受难曲》。(1)作品第一次演出就以完败告终,公众领会不到巴赫的音乐所隐喻的'宇宙奥秘'。那么,巴赫的非凡力量表现在何处呢?神学家断言,巴赫应该被尊为'第五福音'的传道者;音乐文化史家则说,巴赫是'巴洛克音乐的高峰及终结';比较晚近的音乐理论家和美学家还激进地认为,巴赫在《马太受难曲》中把'钉他于十字架'配以音乐。展开更多
文摘Background and Purpose:There is evidence of unequal access to health care int erventions even where universal health systems operate. We investigated associat ions between patients’sociodemographic characteristics and the provision of acu te and longer-term stroke care in a multiethnic urban population.Methods:We us ed data from 1635 patients with first-ever stroke, collected by a population-b ased stroke register from 1995 to 2000. Using multivariable analyses, controlled for sociodemographic and clinical factors, we investigated access to 22 evidenc e-based components of care. Results:1392 patients(85.1%) were admitted to hos pital; of these, 354 (25.4%) were admitted or transferred to a stroke unit. Of those with clinical need, 607 (70.7%) received physical therapies; 477 (59.8%) received speech and language therapy. Older age was associated with lower odds of hospitalization (odds ratio [OR], 0.50; 95%CI, 0.32 to 0.77, P=0.02) and dia gnostic brain imaging (OR,0.15; 95%CI, 0.08 to 0.30, P < 0.01) but higher odds of receiving physical therapy (OR, 4.24;95%CI, 1.22 to 14.73,P < 0.01).Black et hnicity was associated with higher odds of stroke unit admission (OR, 1.59; 95% CI, 1.01 to 2.49, P < 0.04). There was a weak association between socioeconomic status and admission to hospital and stroke unit. Gender was associated only wit h treatment of hypertension before stroke. Conclusions:Provision of individual components of care over 1 year varied for specific sociodemographic categories, but there was no consistent pattern of in equality. Clinical decision-making pr ocesses are likely to influence these patterns. Further information about clinic ian and patient roles in decision making is required.
文摘引言1728年,身为克腾侯爵宫廷乐队指挥的巴赫(Johann Sebastian Bach,1685-1750)以《马太福音》基督被捕和受难的情节为文本基础,利用亨利奇的宗教诗文,创作了《马太受难曲》。(1)作品第一次演出就以完败告终,公众领会不到巴赫的音乐所隐喻的'宇宙奥秘'。那么,巴赫的非凡力量表现在何处呢?神学家断言,巴赫应该被尊为'第五福音'的传道者;音乐文化史家则说,巴赫是'巴洛克音乐的高峰及终结';比较晚近的音乐理论家和美学家还激进地认为,巴赫在《马太受难曲》中把'钉他于十字架'配以音乐。
