Lostao Lourdes, Regidor Enrique, Geyer Siegfried, Aïach Pierre
Department of Sociology, Universidad Pública de Navarra, Campus de Arrosadía, 31006 Pamplona-Navarra, Spain.
J Epidemiol Community Health. 2007 May;61(5):416-20. doi: 10.1136/jech.2006.047126.
The association between educational level and the probability of physician visits in three Western European countries, one of which has a system of patient cost sharing was evaluated. Cross-sectional surveys were performed in France, Germany and Spain around 1990 and around 2000. People representative of the French, German and Spanish populations, aged 25-74 years were studied. The probability of physician visits decreased in the second period with respect to the first in France and Germany, but it increased in Spain. In the two periods studied, subjects with low educational level had a lower probability of physician visits than those with high educational level in France, in contrast with the general trend in Germany and Spain. In both periods, France had patient cost sharing whereas Germany and Spain did not. The existence of patient cost sharing in the healthcare systems of Western European countries raises doubts about the possibility of making use of health services independent of individual socioeconomic position.
对三个西欧国家教育水平与就医概率之间的关联进行了评估，其中一个国家实行患者费用分担制度。1990年左右和2000年左右在法国、德国和西班牙开展了横断面调查。研究对象为年龄在25至74岁之间、具有法国、德国和西班牙人口代表性的人群。在法国和德国，第二个时期的就医概率相对于第一个时期有所下降，但在西班牙则有所上升。在研究的两个时期内，法国教育水平低的受试者就医概率低于教育水平高的受试者，这与德国和西班牙的总体趋势相反。在这两个时期，法国都实行患者费用分担制度，而德国和西班牙则没有。西欧国家医疗保健系统中患者费用分担制度的存在，引发了对于能否独立于个人社会经济地位使用医疗服务的质疑。
