Social Inequalities in Perceived Health and the Use of Health Services in a Southern European Urban Area

1999 ◽  
Vol 29 (4) ◽  
pp. 743-764 ◽  
Author(s):  
Carme Borrell ◽  
Izabella Rohlfs ◽  
Josep Ferrando ◽  
M. Isabel Pasarín ◽  
Felicitas Domínguez-Berjón ◽  
...  
Author(s):  
Carme Borrell ◽  
Izabella Rohlfs ◽  
Josep Ferrando ◽  
M. Isabel Pasarín ◽  
Felicitas Domínguez-Berjón ◽  
...  

2011 ◽  
Vol 27 (suppl 2) ◽  
pp. s198-s208 ◽  
Author(s):  
Marilisa Berti de Azevedo Barros ◽  
Priscila Maria Stolses Bergamo Francisco ◽  
Margareth Guimarães Lima ◽  
Chester Luiz Galvão César

The aim of the present study was to assess social inequalities in health status, health behavior and the use of health services based on education level. A population-based cross-sectional study was carried out involving 1,518 elderly residents of Campinas, São Paulo State, Brazil. Significant demographic and social differences were found between schooling strata. Elderly individuals with a higher degree of schooling are in greater proportion alcohol drinkers, physically active, have healthier diets and a lower prevalence of hypertension, diabetes, dizziness, headaches, back pain, visual impairment and denture use, and better self-rated health. But, there were no differences in the use of health services in the previous two weeks, in hospitalizations or surgeries in the previous year, nor in medicine intake over the previous three days. Among elderly people with hypertension and diabetes, there were no differences in the regular use of health services and medication. The results demonstrate social inequalities in different health indicators, along with equity in access to some health service components.


2019 ◽  
Author(s):  
Wenhui Mao ◽  
Yaoguang Zhang ◽  
Ling Xu ◽  
Zhiwen Miao ◽  
Di Dong ◽  
...  

Abstract Background China’s rapidly aging population is raising many challenges for the delivery and financing of health care. The Urban Residents Basic Medical Insurance (URBMI) has provided financial protection for the urban elderly population not covered by other health insurance schemes since 2007. We conducted a national level assessment to measure on the perceived health needs of this population as well as their use of health services. Methods Data on individuals over the age of 60 were extracted from two National Health Service Surveys conducted in 2008 and 2013. Multivariate regression models were used to estimate associations of socioeconomic factors and perceived health needs with the use of health services while controlling for demographic characteristics and year of survey. Findings Perceived health needs increased significantly between 2008 and 2013, regardless of insurance enrollment, age group or income level. In 2013, over 75% of individuals reported having at least one Non-communicable disease (NCD). Outpatient services decreased for those without insurance but increased for those with insurance. Middle- and high-income groups with insurance experienced a faster growth in outpatient visits and hospital admissions than the low-income group. Proportion of forgone hospital admissions, and proportion of forgone hospital admissions due to financial difficulties decreased. Yet there were still over 20% elderly forgone necessary hospital admissions, among which more than 40% were caused by financial barriers in 2013. Multivariate regression models found an increase of outpatient visits and hospital admissions from 2008 to 2013 when controlling for socioeconomic and health need factors. Conclusion Perceived health needs among the elderly increased at an alarming rate, and results showed a high prevalence of NCDs. Use of overall services increased and forgone necessary admissions decreased after the implementation of URBMI, indicating the improvement of access to health services. However, high-income groups had the highest increase in service use calling for further attention to issues related to equity. The service benefit packages offered by health insurance schemes should provide more support to the care of NCD patients.


2021 ◽  
Vol 10 (13) ◽  
pp. 2786
Author(s):  
Marta Fuentes-Alonso ◽  
Marta Lopez-Herranz ◽  
Ana López-de-Andrés ◽  
Zichen Ji ◽  
Rodrigo Jiménez-García ◽  
...  

(1) Background: To assess the prevalence of mental disorders (depression and anxiety), psychological distress, and psychiatric medications consumption among persons suffering from COPD; to compare this prevalence with non-COPD controls and to identify which variables are associated with worse mental health. (2) Methods: This is an epidemiological case-control study. The data were obtained from the Spanish National Health Survey 2017. Subjects were classified as COPD if they reported suffering from COPD and the diagnosis of this condition had been confirmed by a physician. For each case, we selected a non-COPD control matched by sex, age, and province of residence. Conditional logistic regression was used for multivariable analysis. (3) Results: The prevalence of mental disorders (33.9% vs. 17.1%; p < 0.001), psychological distress (35.4% vs. 18.2%; p < 0.001), and psychiatric medications consumption (34.1% vs. 21.9%; p < 0.001) was higher among COPD cases compared with non-COPD controls. After controlling for possible confounding variables, such as comorbid conditions and lifestyles, using multivariable regression, the probability of reporting mental disorders (OR 1.41; 95% CI 1.10–1.82).), psychological distress (OR 1.48; 95% CI 1.12–1.91), and psychiatric medications consumption (OR 1.38 95% CI 1.11–1.71) remained associated with COPD. Among COPD cases, being a woman, poor self-perceived health, more use of health services, and active smoking increased the probability of suffering from mental disorders, psychological distress, and psychiatric medication use. Stroke and chronic pain were the comorbidities more strongly associated with these mental health variables. (4) Conclusions: COPD patients have worse mental health and higher psychological distress and consume more psychiatric medications than non-COPD matched controls. Variables associated with poorer mental health included being a woman, poor self-perceived health, use of health services, and active smoking.


2008 ◽  
Vol 98 (11) ◽  
pp. 2011-2020 ◽  
Author(s):  
Arijit Nandi ◽  
Sandro Galea ◽  
Gerald Lopez ◽  
Vijay Nandi ◽  
Stacey Strongarone ◽  
...  

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