Social class inequalities in the utilization of health care and preventive services in Spain, a country with a national health system.
In Spain, despite the existence of a National Health System (NHS), the utilization of some curative health services is related to social class. This study assesses (1) whether these inequalities are also observed for preventive health services and (2) the role of additional private health insurance...
| Publicado en: | International Journal of Health Services Vol. 40; no. 3; pp. 525 - 543 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105032690&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105032690 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00207314 E6D jtl: International Journal of Health Services issn: 00207314 maglogo: Y pubinfo: dt: 2010 vid: 40 iid: 3 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 105032690 105032690 2010690092 10.2190/hs.40.3.h NLM20799674 105032690 ppf: 525 ppct: 18 formats: tig: atl: Social class inequalities in the utilization of health care and preventive services in Spain, a country with a national health system. aug: au: Garrido-Cumbrera M Borrell C Palència L Espelt A Rodríguez-Sanz M Pasarín MI Kunst A sug: subj: Health Resource Utilization Evaluation Social Class Adolescence Adult Aged Confidence Intervals Descriptive Statistics Female Funding Source Health Status Evaluation Human Insurance, Health Interviews Male Middle Age Poisson Distribution Questionnaires Self Assessment Self Report Sex Factors Spain Surveys Adolescent: 13-18 years Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Female Male ab: In Spain, despite the existence of a National Health System (NHS), the utilization of some curative health services is related to social class. This study assesses (1) whether these inequalities are also observed for preventive health services and (2) the role of additional private health insurance for people of advantaged social classes. Using data from the Spanish National Health Survey of 2006, the authors analyze the relationships between social class and use of health services by means of Poisson regression models with robust variance, controlling for self-assessed health. Similar analyses were performed for waiting times for visits to a general practitioner (GP) and specialist. After controlling for self-perceived health, men and women from social classes IV-V had a higher probability of visiting the GP than other social classes, but a lower probability of visiting a specialist or dentist. No large class differences were observed in frequency of hospitalization or emergency services use, or in breast cancer screening or influenza vaccination; cervical cancer screening frequency was lower among women from social classes IV-V. The inequalities in specialist visits, dentist visits, and cervical cancer screening were larger among people with only NHS insurance than those with double health insurance. Social class differences in waiting times were observed for specialist visits, but not for GP visits. Men and women from social classes IV-V had longer waits for a specialist; this was most marked among people with only NHS insurance. Clearly, within the NHS, social class inequalities are still evident for some curative and preventive services. Further research is needed to identify the factors driving these inequalities and to tackle these factors from within the NHS. Priority areas include specialist services, dental care, and cervical cancer screening. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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