Socioeconomic inequity in health care: A study of services utilization in Curacao

被引:40
作者
Alberts, JF [1 ]
Sanderman, R [1 ]
Eimers, JM [1 ]
VandenHeuvel, WJA [1 ]
机构
[1] MED & PUBL HLTH SERV CURACAO,EPIDEMIOL & RES UNIT,CURACAO,NETH ANTILLES
关键词
health care utilization; equity; need; Curacao;
D O I
10.1016/S0277-9536(96)00338-3
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
The aim of this study is to examine whether there is socioeconomic equity in health care utilization in Curacao, Netherlands Antilles. We explore how educational level is related to utilization of GPs, specialists, hospitals, dentists and physiotherapists, taking into account the effects of sex, age and inequalities in health. The study also examines whether these relationships vary according to the unit of analysis: probability (or incidence) of services use versus overall volume of contacts. The data were derived from the Curacao Health Study, a health interview survey among a random sample (N = 2248) of the non-institutionalized population aged 18 and over. The results indicate that there is socioeconomic inequity in the probability of health care utilization in Curacao. People with a higher educational level are more likely to consult a specialist, dentist or physiotherapist, and are also more likely to be hospitalized. This is not only the case when the mediating effects of socioeconomic inequalities in health (need) are taken into account, but also before adjustment for health inequalities. In other words: there appears to be both vertical inequity (i.e. greater needs for services ate not met by greater use) and horizontal inequity (i.e. similar needs for care are not met by similar levels of services use). The observed inequalities in use of specialists and hospitals contrast with findings from international research. The volume of health services use (i.e. the numbers of consultations) appears to be hardly connected with a person's position in the SES hierarchy; only dental services are used more extensively by higher educated individuals. (C) 1997 Elsevier Science Ltd.
引用
收藏
页码:213 / 220
页数:8
相关论文
共 38 条
[1]  
Aday L A, 1974, Health Serv Res, V9, P208
[2]   HEALTH-INSURANCE AND UTILIZATION OF MEDICAL-CARE FOR CHILDREN WITH SPECIAL HEALTH-CARE NEEDS [J].
ADAY, LA ;
LEE, ES ;
SPEARS, B ;
CHUNG, CW ;
YOUSSEF, A ;
BLOOM, B .
MEDICAL CARE, 1993, 31 (11) :1013-1026
[3]   SOCIOECONOMIC INEQUALITIES IN HEALTH - NO EASY SOLUTION [J].
ADLER, NE ;
BOYCE, WT ;
CHESNEY, MA ;
FOLKMAN, S ;
SYME, SL .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 269 (24) :3140-3145
[4]  
ALBERTS JF, 1996, CURACAO HTLH STUDY M
[5]   ACCESS TO MEDICAL-CARE IN UNITED-STATES - REALIZED AND POTENTIAL [J].
ANDERSEN, R ;
ADAY, LA .
MEDICAL CARE, 1978, 16 (07) :533-546
[6]   SOCIETAL AND INDIVIDUAL DETERMINANTS OF MEDICAL CARE UTILIZATION IN UNITED-STATES [J].
ANDERSEN, R ;
NEWMAN, JF .
MILBANK MEMORIAL FUND QUARTERLY-HEALTH AND SOCIETY, 1973, 51 (01) :95-124
[7]  
[Anonymous], 1992, RAND 36 ITEM HLTH SU
[8]  
BERNTS T, 1991, LEVEN ZONDER ZORG OO
[9]  
DESWAAN A, 1979, HET SPREEKUUR ALS OP, V2
[10]   PHYSICIANS CHARACTERISTICS INFLUENCE PATIENTS ADHERENCE TO MEDICAL-TREATMENT - RESULTS FROM THE MEDICAL OUTCOMES STUDY [J].
DIMATTEO, MR ;
SHERBOURNE, CD ;
HAYS, RD ;
ORDWAY, L ;
KRAVITZ, RL ;
MCGLYNN, EA ;
KAPLAN, S ;
ROGERS, WH .
HEALTH PSYCHOLOGY, 1993, 12 (02) :93-102