The gender gap in primary health care resource utilization in Central Asia
The gender gap in primary health care resource utilization in Central Asia
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DOI：
10.1093/heapol/17.3.264
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发表时间：
2002-09-01
影响因子：
3.2
通讯作者：
Zuess, O
中科院分区：
文献类型：
--
作者：
Cashin, CE;Borowitz, M;Zuess, O
在前苏联的一些国家，预期寿命存在很大的性别差距。男性的预期寿命比女性少13岁，男性超额死亡率的很大一部分是由心血管疾病引起的。尽管有效的初级卫生保健对于管理心血管疾病和减少急性发作和死亡率是必要的，但该区域成年男子对初级卫生保健系统的利用不足。本研究将分类利用数据与成本数据相结合，分析了哈萨克斯坦和乌兹别克斯坦城乡人均初级保健资源的消费模式。结果表明，从绝对值和人均值来看，初级卫生保健的主要使用者是育龄妇女和五岁以下儿童。根据服务的利用率和费用，育龄妇女消耗的人均初级保健资源大约是人均初级保健资源的1.5倍，而同年龄组的男子消耗的大约是平均水平的一半。五岁以下儿童消耗的资源大约是人均初级保健资源的三到五倍。根据这项研究的结果，地区政府卫生购买者与医疗服务提供者合作，制定了一种新的人均支付制度，调整了年龄/性别，并鼓励扩大服务，将成年男子纳入初级保健制度。
There is a large gender gap in life expectancy in some countries of the former Soviet Union. Life expectancy of males is as much as 13 years less than that of females, and a significant portion of the excess male mortality is caused by cardiovascular disease. Although effective primary health care is necessary to manage cardiovascular disease and reduce acute episodes and mortality, the primary health care system is under-utilized by adult males in the region. This study combines disaggregated utilization data with cost data to analyze patterns of per capita primary care resource consumption in urban and rural regions of Kazakhstan and Uzbekistan. The results show that both in absolute and per capita terms, the principal users of primary health are women of reproductive age and children under five. Based on a combination of utilization and cost of services, women of reproductive age consume approximately 1.5 times the average per capita primary health care resources, while men in the same age group consume approximately one-half of the average. Children under five consume about three to five times the average per capita primary care resources. Based on the results of the study, regional government health purchasers worked together with providers to develop a new per capita payment system with age/sex adjustments and incentives for outreach to bring adult men into the primary care system.