Equity of access to health care services: Theory and evidence from the UK
Equity of access to health care services: Theory and evidence from the UK
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DOI：
10.1016/s0277-9536(00)00415-9
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发表时间：
2001-11-01
影响因子：
5.4
通讯作者：
Smith, P
中科院分区：
文献类型：
--
作者：
Goddard, M;Smith, P
追求公平获得卫生保健是许多卫生保健系统的中心目标。本文首先提出了一个一般性的理论框架，在此框架内可以审查机会平等问题。然后，它适用的框架，研究证据已经能够检测到系统的不公平的访问在英国，公平的访问一直是一个中心的焦点，在国家卫生服务，自1948年成立以来的程度。社会经济群体之间的不平等是作为一个说明性的例子，和程度的不平等的访问经历了五个服务领域的探讨：全科医生咨询;急性医院护理;心理健康服务;预防医学和健康促进;和长期保健。该文件的结论是，在英国获得某些类型的医疗保健似乎存在重要的不公平现象，但证据往往是方法上的不足，很难得出明确的结论。特别是，很难确定不平等的原因，这反过来又限制了建议适当政策以减少获得机会不平等的范围。从英国的理论框架和经验教训是直接相关的研究人员从其他国家寻求审查公平的机会，在各种各样的机构设置。(C)2001爱思唯尔科技有限公司版权所有。
The pursuit of equity of access to health care is a central objective of many health care systems. This paper first sets out a general theoretical framework within which equity of access can be examined. It then applies the framework by examining the extent to which research evidence has been able to detect systematic inequities of access in UK, where equity of access has been a central focus in the National Health Service since its inception in 1948. Inequity between socio-economic groups is used as an illustrative example, arid the extent of inequity of access experienced is explored in each of five service areas: general practitioner consultations; acute hospital care; mental health services; preventative medicine and health promotion; and long-term health care. The paper concludes that there appear to be important inequities in access to some types of health care in the UK, but that the evidence is often methodologically inadequate, making it difficult to draw firm conclusions. In particular, it is difficult to establish the causes of inequities which in turn limits the scope for recommending appropriate policy to reduce inequities of access. The theoretical framework and the lessons learned from the UK are of direct relevance to researchers from other countries seeking to examine equity of access in a wide variety of institutional settings. (C) 2001 Elsevier Science Ltd. All rights reserved.