Estimating the demand for health services in four poor districts of Cape Town, South Africa
Estimating the demand for health services in four poor districts of Cape Town, South Africa
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DOI：
10.1016/j.inhe.2011.01.004
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发表时间：
2011-03-01
影响因子：
2.5
通讯作者：
Mills, Anne
中科院分区：
文献类型：
--
作者：
Skordis-Worrall, Jolene;Hanson, Kara;Mills, Anne
在南非，医疗保健需求的差异可能会使疾病发生率、发病率和生存率的不平等永久化。本文提出了两种模型的医疗需求：一个估计使用任何服务的概率，和其他用户之间的访问量建模。我们发现，使用的预测性别，感知的财务状况，心理和身体健康，家庭外资源和私人咨询的价格。就诊次数是根据年龄、身心健康、家庭外资源和私人提供者的质量来预测的。这些调查结果表明，需求并非毫无意义：家庭外资金使人们能够获得服务;如果病人负担不起私人护理，他们可能选择不寻求护理;男性在健康状况不佳的情况下寻求护理的可能性低于女性。获得医疗服务所需的资金表明，地方公共服务没有为最弱势群体履行其“安全网”职能。政策制定者应考虑是否可以针对无法获得额外资金的家庭提供援助。鼓励男子在疾病变得严重之前使用服务，可以增加传染病的早期发现，改善个人健康结果和公共健康后果。(C)2011年皇家热带医学和卫生学会。由爱思唯尔有限公司发布。保留所有权利。
In South Africa, differences in healthcare demand may perpetuate inequities in disease incidence, morbidity and survival. This paper presents two models of healthcare demand: one estimating the probability of using any service, and the other modelling the number of visits among users. We find that use is predicted by gender, perceived financial situation, mental and physical health, extra-household resources and the price of a private consultation. The number of visits is predicted by age, physical and mental health, extra-household resources and private provider quality. These findings indicate that demand is not frivolous: extra-household funds enable access: patients may choose not to seek care if they cannot afford private care: and men are less likely to seek care at the same level of ill-health as women. The need for funds to access care suggests that local public services are not fulfilling their 'safety net' function for the most vulnerable. Policy makers should consider whether they can target assistance to households without access to extra funds. Encouraging men to use services before an illness becomes severe may increase early identification of infectious diseases, improving both individual health outcomes and public health consequences. (C) 2011 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.