Author:
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Bosch de Basea, Magda; Espinosa Cardiel, Ana; Gil, Mariona; Figuerola, Jordi; Pardina, Marina; Vilar, José; Cardis, Elisabeth
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Abstract:
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Recent publications reported that children in disadvantaged
areas undergo more CT scanning than others. The present study is
aimed to assess the potential differences in CT imaging by
socioeconomic status (SES) in Spanish young scanned subjects and
if such differences vary with different indicators or different
time point SES measurements. The associations between CT
scanning and SES, and between the CT scan rate per patient and
SES were investigated in the Spanish EPI-CT subcohort. Various
SES indicators were studied to determine whether particular SES
dimensions were more closely related to the probability of
undergoing one or multiple CTs. Comparisons were made with
indices based on 2001 and 2011 censuses. We found evidence of
socio-economic variation among young people, mainly related to
autonomous communities of residence. A slightly higher rate of
scans per patient of multiple body parts in the less affluent
categories was observed, possibly reflecting a higher rate of
accidents and violence in these groups. The number of CT scans
per patient was higher both in the most affluent and the most
deprived categories and somewhat lower in the intermediate
groups. This relation varied with the SES indicator used, with
lower CT scans per patients in categories of high unemployment
and temporary work, but not depending on categories of unskilled
work or illiteracy. The relationship between these indicators
and number of CTs in 2011 was different than that seen with the
2001 census, with the number of CTs increasing with higher
unemployment. Overall we observed some differences in the SES
distribution of scanned patients by Autonomous Community in
Spain. There was, however, no major differences in the frequency
of CT scans per patient by SES overall, based on the 2001
census. The use of different indicators and of SES data
collected at different time points led to different relations
between SES and frequency of CT scans, outlining the difficulty
of adequately capturing the social and economic dimensions which
may affect health and health service utilisation. |