Socio-economic status, chronic morbidity and health services utilization by families

Abstract Background Assessing inequities in health services utilization contributes to build effective strategies for health equity promotion. This study aimed to evaluate the socioeconomic inequalities and inequities in health services utilization among hypertensive patients and explore the changes between 2015 and 2019 in Pearl River Delta of China. Methods The cross-sectional surveys were conducted using the questionnaire. Eight hundred thirty and one thousand one hundred sixty-six hypertensive patients in 2015 and 2019 were interviewed, respectively. The concentration index (CI) and the horizontal inequity index (HI) were used to access the socioeconomic inequalities and horizontal inequities in outpatient and inpatient health services use. The contribution of influential factors to the overall inequalities was estimated via the concentration index decomposition. Oaxaca-type decomposition technique was utilized to measure the changes in socioeconomic inequalities between the observation periods. Results In 2015 and 2019, the CIs for outpatient and inpatient utilization decreased from 0.1498 to 0.1198, 0.1982 to 0.1648, respectively, and the HIs for outpatient and inpatient utilization decreased from 0.1478 to 0.1078, 0.1956 to 0.1390, respectively. Economic status contributed the maximum ratio of the socioeconomic inequalities in the use of outpatient service (81.05% in 2015, 112.89% in 2019) and inpatient service (82.46% in 2015, 114.68% in 2019) in these 2 years. Oaxaca decomposition revealed that educational level (78.30% in outpatient, 53.79% in inpatient) and time to the nearest health facilities (66.78% in outpatient, 31.06% in inpatient) made the main positive contributions to decline the inequalities. While the main factor pushing the equalities toward deterioration was economic status (− 46.11% in outpatient, −76.56% in inpatient). Conclusion There were certain declines in the socioeconomic inequalities and inequities in health services utilization by hypertensive patients in Pearl River Delta of China over time. The widening economic gap was the largest contribution to the observed inequalities. Interventions to protect the vulnerable group deserve further concern from policy makers.

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Socio-economic inequalities in health services utilization: a cross-sectional study

International Journal of Health Care Quality Assurance ◽

10.1108/ijhcqa-04-2017-0059 ◽

2018 ◽

Vol 31 (1) ◽

pp. 69-75 ◽

Cited By ~ 3

Author(s):

Mohammad Ranjbar Ezzatabadi ◽

Ameneh Khosravi ◽

Mohammad Amin Bahrami ◽

Sima Rafiei

Keyword(s):

Health Services ◽

Health Services Utilization ◽

Economic Status ◽

Cross Sectional Study ◽

Influential Factors ◽

Sectional Study ◽

Cross Sectional ◽

Content Type ◽

Services Utilization ◽

Isfahan Province

Purpose Developing country workers mainly face important challenges when examining equality in health services utilization among the population and identifying influential factors. The purpose of this paper us to: understand health service use among households with different socio-economic status in Isfahan province; and to investigate probable inequality determinants in service utilization. Design/methodology/approach Almost 1,040 households living in Isfahan province participated in this cross-sectional study in 2013. Data were collected by a questionnaire with three sections: demographic characteristics; socio-economic status; and health services utilization. The concentration index was applied to measure inequality. Analysts used STATA 11. Findings Economic status, educational level, insurance coverage and household gender were the most influential factors on health services utilization. Those with a high socio-economic level were more likely to demand and use such services; although self-medication patterns showed an opposite trend. Practical implications Female-headed families face with more difficulties in access to basic human needs including health. Supportive policies are needed to meet their demands. Originality/value The authors used principle component analysis to assess households’ economic situation, which reduced the variables into a single index.

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Nonelective hospital admissions, discharge disposition, and health services utilization in epilepsy patients: A population‐based study

Epilepsia ◽

10.1111/epi.16642 ◽

2020 ◽

Vol 61 (9) ◽

pp. 1969-1978

Author(s):

Churl‐Su Kwon ◽

Bonnie Wong ◽

Parul Agarwal ◽

Jung‐Yi Lin ◽

Madhu Mazumdar ◽

...

Keyword(s):

Health Services ◽

Hospital Admissions ◽

Health Services Utilization ◽

Population Based ◽

Population Based Study ◽

Services Utilization ◽

Discharge Disposition

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Does the implementation of a national oral health policy reduce inequalities in oral health services utilization? The Brazilian experience

BMC Public Health ◽

10.1186/s12889-021-10586-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Maria Helena Rodrigues Galvão ◽

Angelo Giuseppe Roncalli

Keyword(s):

Health Policy ◽

Oral Health ◽

Health Services ◽

Health Services Utilization ◽

Age Groups ◽

Public Access ◽

Services Utilization ◽

Index Of Inequality ◽

Oral Health Services ◽

Oral Health Policy

Abstract Background This study aimed to assess the trend in income-related inequalities in oral health services utilization by the Brazilian population from 1998 to 2013. This period represents a timeline that includes different stages of implementation of the National Oral Health Policy. Methods The design was based on repeated cross-sectional surveys using secondary data from household-based studies carried out in Brazil in 1998, 2003, 2008, and 2013. The dependent variable was “having access to a dentist appointment at least once in a lifetime (yes/no).” Monthly household per capita income, based on Brazil’s minimum wage, was included as the main independent variable. To measure the inequalities in oral health access related to economic position, the following complex indexes based on regression were used: (a) the slope index of inequality (SII) and (b) the relative index of inequality (RII). Results There was a reduction in the percentage of individuals who never had a dentist appointment for all age groups and income classifications. In general, there was a reduction trend in absolute inequality for all age groups (p < 0.001). The relative inequality and reduction trend were different between the age groups studied. Conclusions The National Oral Health Policy was very important for expanding free of charge, public access to dental appointment. However, despite policy implementation, there continues to be high levels of inequality in access to dental consultation. Assessing which strategies are necessary to overcome this challenge is discussed.

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