Assessment of health care needs and utilization in a mixed public-private system: the case of the Athens area.
Assessment of health care needs and utilization in a mixed public-private system: the case of the Athens area.
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DOI：
10.1186/1472-6963-6-146
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发表时间：
2006-11-02
影响因子：
2.8
通讯作者：
Niakas D
中科院分区：
文献类型：
--
作者：
Pappa E;Niakas D
考虑到希腊卫生系统的公私混合，本研究的目的是评估初级和住院医疗卫生服务利用率的变化是否与潜在的卫生保健需求和/或各种社会经济因素相关。数据来自居住在更广泛的雅典地区的代表性样本（N = 1426）（应答率70.6%）。感知的健康相关生活质量（HRQOL），通过SF-36健康调查的身体和精神总结部分评分测量，用作医疗保健需求的代表。卫生保健利用率的衡量标准是：a）上个月对公共部门医生的访问，B）上个月对私营部门医生的访问，c）去年对医院急诊室的访问，d）去年的住院人数。统计分析涉及逻辑回归模型的实施。卫生保健需求是与卫生保健利用的所有措施最密切相关的因素，除了访问公共医生。妇女、老年人、不太富裕的人和身体健康状况较低的人去看与其保险基金签约的医生（公共部门）。受过良好教育的妇女和身体健康状况较低的妇女更有可能去看私人医生。到医院急诊室就诊和住院与需求有关，没有社会经济因素与使用这些类型的护理有关。这项研究显示，在公私营混合的医护制度下，医护服务的需求与使用率之间有正面的关系。与此同时，在利用各种服务方面也明显存在着令人感兴趣的差异。研究结果对卫生政策制定，特别是合理分配稀缺的卫生资源具有潜在的影响。
Given the public-private mix of the Greek health system, the purpose of this study was to assess whether variations in the utilisation of health services, both primary and inpatient care, were associated with underlying health care needs and/or various socio-economic factors. Data was obtained from a representative sample (N = 1426) residing in the broader Athens area (response rate 70.6%). Perceived health-related quality of life (HRQOL), as measured by the physical and mental summary component scores of the SF-36 Health Survey, was used as a proxy of health care need. Health care utilization was measured by a) last-month visits to public sector physicians, b) last-month visits to private sector physicians, c) last-year visits to hospital emergency departments and d) last-year hospital admissions. Statistical analysis involved the implementation of logistic regression models. Health care need was the factor most strongly associated with all measures of health care utilization, except for visits to public physicians. Women, elderly, less wealthy and individuals of lower physical health status visited physicians contracted to their insurance fund (public sector). Women, well educated and those once again of lower physical health status were more likely to visit private providers. Visits to hospital emergency departments and hospital admissions were related to need and no socio-economic factor was related to the use of those types of care. This study has demonstrated a positive relationship between health care need and utilisation of health services within a mixed public-private health care system. Concurrently, interesting differences are evident in the utilization of various types of services. The results have potential implications in health policy-making and particularly in the proper allocation of scarce health resources.
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影响因子：
5.4
作者：
PIPERNO, A;DIORIO, F
通讯作者：
DIORIO, F
影响因子：
5.4
作者：
Smaje, C;LeGrand, J
通讯作者：
LeGrand, J
影响因子：
3.3
作者：
Burström, B
通讯作者：
Burström, B
影响因子：
3
作者：
MANGA, P;BROYLES, RW;ANGUS, DE
通讯作者：
ANGUS, DE
影响因子：
5.4
作者：
NEWBOLD, KB;EYLES, J;BIRCH, S
通讯作者：
BIRCH, S