Equity and equality in the use of GP services for elderly people: The Spanish case

Cebada, Eva Crespo; Urbanos-Garrido, Rosa M.

doi:10.1016/j.healthpol.2011.10.007

Cited by 31 publications

(22 citation statements)

References 25 publications

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“…Three questions on experience of STD symptoms in DHS 2010 and DHS 2004 are used as need variables in the analysis: 1) a diagnosed STD in the last 12 months, 2) a genital sore or ulcer in the last 12 months or 3) genital discharge in the last 12 months. A number of previous studies have used symptoms as need indicators in empirical analyses of equity (29, 30). The symptoms used in this study may be indicators of HIV infection (31), and patients should be referred for an HIV test when these symptoms are observed (31, 32).…”

Section: Methodsmentioning

confidence: 99%

Socio-economic inequity in HIV testing in Malawi

Kim

Skordis‐Worrall²,

Haghparast‐Bidgoli³

et al. 2016

Global Health Action

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BackgroundHuman immunodeficiency virus (HIV) is a significant contributor to Malawi's burden of disease. Despite a number of studies describing socio-economic differences in HIV prevalence, there is a paucity of evidence on socio-economic inequity in HIV testing in Malawi.ObjectiveTo assess horizontal inequity (HI) in HIV testing in Malawi.DesignData from the Demographic and Health Surveys (DHSs) 2004 and 2010 in Malawi are used for the analysis. The sample size for DHS 2004 was 14,571 (women =11,362 and men=3,209), and for DHS 2010 it was 29,830 (women=22,716 and men=7,114). The concentration index is used to quantify the amount of socio-economic-related inequality in HIV testing. The inequality is a primary method in this study. Corrected need, a further adjustment of the standard decomposition index, was calculated. Standard HI was compared with corrected need-adjusted inequity. Variables used to measure health need include symptoms of sexually transmitted infections. Non-need variables include wealth, education, literacy and marital status.ResultsBetween 2004 and 2010, the proportion of the population ever tested for HIV increased from 15 to 75% among women and from 16 to 54% among men. The need for HIV testing among men was concentrated among the relatively wealthy in 2004, but the need was more equitably distributed in 2010. Standard HI was 0.152 in 2004 and 0.008 in 2010 among women, and 0.186 in 2004 and 0.04 in 2010 among men. Rural–urban inequity also fell in this period, but HIV testing remained pro-rich among rural men (HI 0.041). The main social contributors to inequity in HIV testing were wealth in 2004 and education in 2010.ConclusionsInequity in HIV testing in Malawi decreased between 2004 and 2010. This may be due to the increased support to HIV testing by global donors over this period.

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Section: Methodsmentioning

confidence: 99%

Socio-economic inequity in HIV testing in Malawi

Kim

Skordis‐Worrall²,

Haghparast‐Bidgoli³

et al. 2016

Global Health Action

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“…A favor de esta idea está el hecho de que la renta familiar o un mayor nivel de estudios se asocien con menos visitas en el modelo de factores facilitadores. Lo que no se ha observado en el uso de la consulta de enfermería es esa inequidad pro-pobres (discriminación positiva), descrita para la utilización de otro tipo de consultas en AP en los sistemas públicos de salud 3,4,6,[30][31][32][33] . Tampoco se han observado desigualdades en el uso de servicios relativas al sexo.…”

Section: Tabla 4 Modelo Explicativo Final De Las Diferencias En La Utunclassified

Variables que condicionan la utilización de la consulta de enfermería en centros de salud de la Comunidad de Madrid

Fernández¹,

Rodríguez-Martínez

Ariza-Cardiel

et al. 2013

Rev. Esp. Salud Publica

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RESUMENFundamentos: Diferentes condiciones de utilización de servicios sanitarios pueden originar situaciones de falta de equidad. El objetivo del trabajo es conocer si existen diferencias en el uso de la consulta de enfermería en atención primaria.Métodos: Estudio multicéntrico transversal en 23 centros de salud de la Comunidad de Madrid. Se incluyó a 662 sujetos. Se recogieron variables relativas al centro de salud, de la consulta de enfermería, características sociodemograficas y de necesidad en salud. Se estudiaron la calidad de vida y la satisfacción de los sujetos. Las variables se clasificaron, según el modelo "conductual", en predisponentes, facilitadoras o de necesidad. Se construyeron modelos multivariantes explicativos.Resultados: Vivir en zonas de renta alta y la edad se asociaron con aumentos del 17% (IC95%: 0,4-36,9%) y del 11,0% por cada década (IC95%: 6,2-16,2) de las consultas/año de enfermería. De los factores facilitadores, cada minuto añadido de duración de la consulta se asoció con un aumento del 2,0% (IC95%:1,2-2,9%) en las consultas/año, cada nueva consulta médica se asociaba con un aumento del 2,7% (IC95%: 2,1-3,2%) y la demora en conseguir cita superior a un día supuso una disminución del 32,8% (IC95%: 19,3-44,1%) del número de consultas. Cada condición crónica, que expresa necesidad en salud, se asoció con un incremento del número de consultas del 4,8% (IC 95%: 1,7-8,0%). La mejor percepción de la calidad de vida se asoció con una reducción de las consultas de un 5,4% (IC95%: 1,0-8,7%) . Conclusión:Las diferencias en el uso de la consulta de enfermería responde a criterios de necesidad, pero también está influenciada por condiciones de accesibilidad. Methods: Cross-sectional study, in 23 health centres in Madrid. Environmental variables, consultation characteristics, socio-demographic and health need characteristics were collected. The quality of life and satisfaction were also studied. The variables were classified according to the "behavioral model" in predisposing, enabling or need variables. Explanatory multivariate models were constructed (Generalized-EstimatingEquations).Results: The higher income areas and aging, predisposing factors, were associated with increases of 17% (95% CI: 0.4 to 36.9%) and 11.0% per decade (95% CI: 6.2 -16.2) in nursing consultations per year. Among enabling factors, each additional minute of consultation length was associated with an increase of 2.0% (95% CI :1.2-2, 9%) in number of nurse consultations, each new medical consultation was associated with a increase of 2.7% (95% CI: 2.1-3.2%) and the delay in getting appointment over a day, represented a decrease of 32.8% (95% CI: 19.3 to 44.1%) in the total nursing consultations. Each chronic condition, which expresses the need health, was associated with an increase in the number of visits of 4.8% (95% CI: 1.7 to 8.0%). The improved perception of quality of life was associated with a reduction of 5.4% (95% CI 1.0 to 8.7%) of the consultations. Conclusion:The difference of the use of primary care nurse co...

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“…Health inequities in western countries have been reported in many diseases including musculoskeletal disorders [19,20]. Being able to understand the role that the SES plays on the risk of hip fracture can continue to improve health care policies in order to adequately distribute the health care services available.…”

Section: Introductionmentioning

confidence: 99%