Is socioeconomic status associated with utilization of health care services in a single-payer universal health care system?
Is socioeconomic status associated with utilization of health care services in a single-payer universal health care system?
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DOI：
10.1186/s12939-014-0115-1
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发表时间：
2014-11-28
影响因子：
4.8
通讯作者：
Balicer RD
中科院分区：
文献类型：
--
作者：
Filc D;Davidovich N;Novack L;Balicer RD
评估2002年至2008年以色列社会经济地位与医疗保健服务利用率之间的关系。我们回顾性分析了Clalit Health Services的100，000名21岁及以上成员的医疗服务利用情况。该研究根据社区SES状态比较了利用率;以及作为另一个SES代理的诊所位置。数据包括：Charlson评分发病率因子、医疗保健服务利用率（初级医生和专科医生就诊、药品购买、住院天数、艾德就诊、实验室检查和成像利用率）。采用广义线性模型（GLM）技术进行分析。社会经济地位较低的人更多地去看艾德和初级医生，住院时间也更长。SES较高的人看过更多的专家，购买了更多的处方药并使用了更多的医学成像。SES和我们分析的大多数服务之间的关联在2002年至2008年之间没有变化。然而，随着时间的推移，艾德就诊和处方药使用的较低和较高SES水平之间的差距略有增加，而专家就诊的差距有所减少。研究表明，即使在全民医疗保健系统中，社会经济地位也与医疗保健服务的利用有关。为了提高服务利用的公平性，以色列公共卫生部门应减少经济障碍，同时投资于提供信息，以提高所有人的“导航技能”。
To assess an association of Socio-economic status with utilization of health care services between years 2002 and 2008 in Israel. We retrospectively analyzed the utilization of health care services in a cohort of 100,000 members, 21 years and older, of a Clalit Health Services. The research compared utilization according to the neighborhood SES status; and clinic’s location as another SES proxy. Data included: Charlson Score morbidity factor, utilization of health care services (visits to primary physicians and specialists, purchase of pharmaceuticals, number of hospitalization days, visits to ED, utilization of laboratory tests and imaging). The analysis was performed using Generalized Linear Model (GLM) technique. People with lower SES visited more the ED and primary physicians and were hospitalized for longer periods. People with higher SES visited more specialists, bought more prescription drugs and used more medical imaging. The associations between SES and most of the services we analyzed did not change between 2002 and 2008. However, the gap between lower and higher SES levels in ED visits and the use of prescription drugs slightly increased over time, while the gap in visits to specialists decreased. The research shows that even in a universal health care system SES is associated with utilization of health care services. In order to improve equity in utilization of services the Israeli public health should reduce economic barriers and in parallel invest in making information accessible to improve “navigation skills” for all.
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影响因子：
4.4
作者：
Domínguez-Berjón, F;Borrell, C;Pastor, V
通讯作者：
Pastor, V
影响因子：
3.4
作者：
Baron-Epel, Orna;Garty, Noga;Green, Manfred S.
通讯作者：
Green, Manfred S.
DOI：
10.1002/art.11200
发表时间：
2003-08-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Jacobi, CE;Mol, GD;Van den Bos, GAM
通讯作者：
Van den Bos, GAM
影响因子：
3.1
作者：
Curtis, Lori J.;MacMinn, William J.
通讯作者：
MacMinn, William J.
影响因子：
5.1
作者：
Borrell, C;Rue, M;Fernandez, E
通讯作者：
Fernandez, E