Socioeconomic inequities in health services' utilization following the Health Transformation Plan initiative in Iran

被引:20
作者
Abouie, Abolfazl [1 ]
Majdzadeh, Reza [2 ]
Khabiri, Roghayeh [3 ]
Hamedi-Shahraki, Soudabeh [4 ,5 ]
Razavi, Seyed Hasan Emami [6 ,7 ]
Yekaninejad, Mir Saeed [8 ]
机构
[1] Univ Tehran Med Sci, Sch Med & Publ Hlth, Poursina Ave,POB 6446, Tehran 14155, Iran
[2] Univ Tehran Med Sci, Sch Publ Hlth, Community Based Participatory Res Ctr, Knowledge Utilizat Res Ctr, Poursina Ave,POB 6446, Tehran 14155, Iran
[3] Tabriz Univ Med Sci, Tabriz Hlth Serv Management Res Ctr, Mehrgan 7 Ave,POB 009841, Tabriz, Iran
[4] Zabol Univ Med Sci, Dept Epidemiol & Biostat, Shahid Rajaei Ave,POB 9861615881, Zabol, Iran
[5] Univ Tehran Med Sci, Dept Epidemiol & Biostat, Poursina Ave,POB 6446, Tehran 14155, Iran
[6] Univ Tehran Med Sci, Neurosci Inst, Brain & Spinal Cord Injury Res Ctr BASIR, Keshavarz Ave,POB 1419733141, Tehran, Iran
[7] Univ Tehran Med Sci, Med Fac, Tehran, Iran
[8] Univ Tehran Med Sci, Sch Publ Hlth, Dept Epidemiol & Biostat, Poursina Ave,POB 6446, Tehran 14155, Iran
关键词
Inequality; health services; utilization; INCOME INEQUALITY; CARE UTILIZATION; GENDER INEQUALITY; FAMILY-STRUCTURE; DETERMINANTS; INSURANCE; MORTALITY; EDUCATION; EQUITY; HIV;
D O I
10.1093/heapol/czy096
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Health equity has become a progressively popular research topic in recent years. Therefore, this study was made to identify the contributions made by socioeconomic determinants in order to quantify their roles to healthcare utilization inequity and to show their status especially after the recent reform in Iran, i.e. Health Transformation Plan, which one of its main goals is providing access to healthcare for all people. This study is a cross-sectional study conducted on a national level in Iran in 2015. For the sampling frame, three-stage cluster sampling was used. A total of 22470 households from the whole country were surveyed by questionnaires through face-to-face interviews. A total of 78 378 subjects responded to the survey, 18 984 subjects (24.2%) reported the need to outpatient healthcare services in the 2weeks preceding the interview and 12 944 (68.2%) of them had utilized the outpatient services. In addition, 5928 participants (7.6% of total population) reported the need to inpatient healthcare in the 15-month interval prior to the interview. Of these, 5405 subjects (91.2%) had received the inpatient cares. Several factors such as age group, education, marital status and status of household economy play significant roles in seeking inpatient cares. In addition, age group and household economic status have significant impacts on the utilization of outpatient services. While there are several variables that have different effects in determining the need for both outpatient and inpatient services, most of them are not any more significant than what are on the receiving end of these services.
引用
收藏
页码:1065 / 1072
页数:8
相关论文
共 44 条
[1]  
Aday L A, 1974, Health Serv Res, V9, P208
[2]   Measuring Socioeconomic Differences in Use of Health Care Services by Wealth Versus by Income [J].
Allin, Sara ;
Masseria, Cristina ;
Mossialos, Elias .
AMERICAN JOURNAL OF PUBLIC HEALTH, 2009, 99 (10) :1849-1855
[3]   FAMILY-STRUCTURE, PARENTAL PRACTICES AND HIGH-SCHOOL COMPLETION [J].
ASTONE, NM ;
MCLANAHAN, SS .
AMERICAN SOCIOLOGICAL REVIEW, 1991, 56 (03) :309-320
[4]  
Bernard B.P., 1997, MUSCULOSKELETAL DISO, DOI DOI 10.1016/J.APERG0.2011.12.001
[5]   Family structure, educational attainment, and socioeconomic success: Rethinking the "pathology of matriarchy" [J].
Biblarz, TJ ;
Raftery, AE .
AMERICAN JOURNAL OF SOCIOLOGY, 1999, 105 (02) :321-365
[6]   Decomposing the causes of socioeconomic-related health inequality among urban and rural populations in China: a new decomposition approach [J].
Cai, Jiaoli ;
Coyte, Peter C. ;
Zhao, Hongzhong .
INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH, 2017, 16
[7]   Household out-of-pocket medical expenditures and national health insurance in Taiwan: income and regional inequality [J].
Chu, TB ;
Liu, TC ;
Chen, CS ;
Tsai, YW ;
Chiu, WT .
BMC HEALTH SERVICES RESEARCH, 2005, 5 (1)
[8]   MENTAL HEALTH AND WORKING CONDITIONS IN EUROPE [J].
Cottini, Elena ;
Lucifora, Claudio .
ILR REVIEW, 2013, 66 (04) :958-988
[9]   Equity and equality in the use of GP services for elderly people: The Spanish case [J].
Crespo-Cebada, Eva ;
Urbanos-Garrido, Rosa M. .
HEALTH POLICY, 2012, 104 (02) :193-199
[10]   The global impact of income inequality on health by age: an observational study [J].
Dorling, Danny ;
Mitchell, Richard ;
Pearce, Jamie .
BMJ-BRITISH MEDICAL JOURNAL, 2007, 335 (7625) :873-875