Health system characteristics and unmet care needs in Europe: an analysis based on EU-SILC data
Health system characteristics and unmet care needs in Europe: an analysis based on EU-SILC data
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DOI：
10.1007/s10198-014-0629-x
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发表时间：
2015-09-01
影响因子：
4.4
通讯作者：
Guillot, Olivier
中科院分区：
文献类型：
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作者：
Chaupain-Guillot, Sabine;Guillot, Olivier
利用2009年欧盟收入和生活条件统计数据的调查数据，本研究探讨了欧洲国家未满足医疗和牙科保健需求的决定因素。特别强调卫生系统特点的影响。考虑了四个因素：医生或牙医的密度、获得执业医师的规则、支付初级保健医生的方法以及自付费用的数额。分析是使用多层逻辑回归模型进行的。对医疗和牙科服务分别进行了回归估计。因变量是受访者是否报告说，在过去的12个月里，他们至少有一次需要治疗，但没有得到治疗。估计结果表明，各国医疗或牙科需求未得到满足的可能性差别很大。这种国家间的差异似乎部分可以用卫生保健筹资方面的差异来解释。事实上，发现家庭自付费用在保健总支出中所占份额与需求未得到满足的可能性之间存在正相关关系。其他背景因素似乎没有发挥重要作用。
Using survey data from the 2009 wave of the European Union Statistics on Income and Living Conditions, this study examines the determinants of unmet needs for medical and dental care in European countries. Special emphasis is put on the impact of health system characteristics. Four factors are taken into account: the density of doctors or dentists, the rules governing access to practitioners, the method of paying primary care physicians, and the amount of out-of-pocket payments. The analysis is carried out using multilevel logistic regression models. Separate regressions are estimated for medical and dental services. The dependent variable is whether respondents reported that, at least once in the last 12 months, they needed care but did not receive it. The estimation results show that the probability of experiencing unmet medical or dental needs varies noticeably across countries. This inter-country variability seems to be partly explained by the differences in the financing of health care. Indeed, a positive link is found between the share of households' out-of-pocket payments in total health expenditure and the probability of unmet needs. The other contextual factors do not seem to play a significant role.