Access to medical care and its association with physical injury in adolescents: a cross-national analysis.

Autor:	Pagnotta VF; Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada vp17ij@brocku.ca., King N; Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada., Donnelly PD; School of Medicine, University of St Andrews, St Andrews, UK., Thompson W; Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada., Walsh SD; Department of Criminology, Bar-Ilan University, Ramat Gan, Israel., Molcho M; Department of Children's Studies, School of Education, University of Galway, Galway, Ireland., Ng K; Faculty of Education, University of Turku, Turku, Finland.; Physical Activity for Health Research Cluster, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.; School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.; Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland., Malinowska-Cieślik M; Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University, Medical College, Krakow, Poland., Pickett W; Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada.; Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
Jazyk:	angličtina
Zdroj:	Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention [Inj Prev] 2023 Feb; Vol. 29 (1), pp. 42-49. Date of Electronic Publication: 2022 Sep 27.
DOI:	10.1136/ip-2022-044701
Abstrakt:	Background: Strong variations in injury rates have been documented cross-nationally. Historically, these have been attributed to contextual determinants, both social and physical. We explored an alternative, yet understudied, explanation for variations in adolescent injury reporting-that varying access to medical care is, in part, responsible for cross-national differences. Methods: Age-specific and gender-specific rates of medically treated injury (any, serious, by type) were estimated by country using the 2013/2014 Health Behaviour in School-aged Children study (n=209 223). Available indicators of access to medical care included: (1) the Healthcare Access and Quality Index (HAQ; 39 countries); (2) the Universal Health Service Coverage Index (UHC; 37 countries) and (3) hospitals per 100 000 (30 countries) then physicians per 100 000 (36 countries). Ecological analyses were used to relate injury rates and indicators of access to medical care, and the proportion of between-country variation in reported injuries attributable to each indicator. Results: Adolescent injury risks were substantial and varied by country and sociodemographically. There was little correlation observed between national level injury rates and the HAQ and UHC indices, but modest associations between serious injury and physicians and hospitals per 100 000. Individual indicators explained up to 9.1% of the total intercountry variation in medically treated injuries and 24.6% of the variation in serious injuries. Conclusions: Cross-national variations in reported adolescent serious injury may, in part, be attributable to national differences in access to healthcare services. Interpretation of cross-national patterns of injury and their potential aetiology should therefore consider access to medical care as a plausible explanation. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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