Información del artículo
Resumen
Un análisis de regresión utilizando la provincia como la unidad de análisis sugiere la existencia de una asociación inversa entre el gasto de medicamentos a través de la Seguridad Social (GMSS) y la renta «per capita» (RPC) (p<0,01). La asociación entre el Indice de Mortalidad Estandarizada (IME) y la RPC no es estadisticamente significativa b (p<0,2)x. El GMSS y la RPC explican conjuntamente un 47% de la variabilidad interprovincial del IME. La asociación entre IME y GMSS se mantiene al controlar por la RPC provincial (p<0.0001); por si solo el GMSS explica estadísticamente un 45,6% de la variabilidad del IME (r=0,67). Análisis ecológicos más complejos podrían mejorar el conocimiento del sistema de condicionantes de las diferencias regionales de mortalidad y morbilidad. Al utilizar estudios ecológicos la distinción entre niveles de organización es esencial para no cometer la falacia ecológica ni la falacia atomística
Palabras clave:
Mortalidad
Gastos sanitarios
Renta «per cápita»
Summary
A regression analysis using the province as the unit of analysi suggests that an inverse relation exists between expenditure on medication through the Social Security and income per capita, (p<0.01). The association betwen the Standardized Mortality Ratio (SMR) and income per capita is not statistically significant (p<0.2). Expenditure throug the Social Security and income per capita together explain 47% of the interprovincial variance in SMRs. The association between SMRs and Social Security expenditure remains constant when provincial income per capita is controlled for (p<0.0001) in case Social Security expenditure alone statistically explains 45.6% of the variation in SMRs (r=0.67). More complex ecological analysis could improve our understanding of the system of determinants of regional differences in mortality and morbidity. When ecological studies are used the distinction between levels of organization is essential to avoid committing either the ecological or atomistic fallacy.
Key words:
Mortality
Health expenditure
Per capita income
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Una versión anterior de este trabajo fue presentada al Primer Congreso Nacional de Salud Pública y Administración Sanitaria (Barcelona, Octubre 1985)
Copyright © 1987. Sociedad Española de Salud Pública y Administración Sanitaria
