Is utilization of health services for HIV patients equal by socioeconomic status? Evidence from the Basque country

被引:4
作者
Garcia-Goni, Manuel [1 ]
Nuno-Solinis, Roberto [2 ]
Orueta, Juan F. [3 ]
Paolucci, Francesco [4 ,5 ]
机构
[1] Univ Complutense Madrid, Dept Econ Aplicada 2, Madrid 28223, Spain
[2] Univ Deusto, Deusto Business Sch, Bilbao, Spain
[3] Osakidetza Basque Hlth Serv, Ctr Salud Astrabudua, Erandio, Spain
[4] Murdoch Univ, Perth, WA, Australia
[5] Univ Bologna, Bologna, Italy
关键词
Inequities; Socioeconomic status; ART; HIV; Universal coverage; ANTIRETROVIRAL TREATMENT; CARE; INFECTION; IMPACT;
D O I
10.1186/s12939-015-0215-6
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Introduction: Access to ART and health services is guaranteed under universal coverage to improve life expectancy and quality of life for HIV patients. However, it remains unknown whether patients of different socioeconomic background equally use different types of health services. Methods: We use one-year (2010-2011) data on individual healthcare utilization and expenditures for the total population (N = 2262698) of the Basque Country. We observe the prevalence of HIV and use OLS regressions to estimate the impact on health utilization of demographic, socioeconomic characteristics, and health status in such patients. Results: HIV prevalence per 1000 individuals is greater the lower the socioeconomic status (0.784 for highest; 2.135 for lowest), for males (1.616) versus females (0.729), and for middle-age groups (26-45 and 46-65). Health expenditures are 11826(sic) greater for HIV patients than for others, but with differences by socioeconomic group derived from a different mix of services utilization (total cost of 13058(sic) for poorest, 14960(sic) for richest). Controlling for health status and demographic variables, poor HIV patients consume more on pharmaceuticals; rich in specialists and hospital care. Therefore, there is inequity in health services utilization by socioeconomic groups. Conclusions: Equity in health provision for HIV patients represents a challenge even if access to treatment is guaranteed. Lack of information in poorer individuals might lead to under-provision while richer individuals might demand over-provision. We recommend establishing accurate clinical guidelines with the appropriate mix of health provision by validated need for all socioeconomic groups; promoting educational programs so that patients demand the appropriate mix of services, and stimulating integrated care for HIV patients with multiple chronic conditions.
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页数:10
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