Mejía-Mejía Aurelio, Sánchez-Gandur Andrés F, Tamayo-Ramírez Juan C
Centro de Investigaciones Económicas, Facultad de Ciencias Económicas, Universidad de Antioquia Colombia.
Rev Salud Publica (Bogota). 2007 Jan-Mar;9(1):26-38. doi: 10.1590/s0124-00642007000100004.
Analysing equity in access to health care in Antioquia, Colombia.
Poorer and richer groups' access to health-care was evaluated, as was that of people with insurance and those without it. A Logit model was estimated for analysing the main determinants of access to curative and preventative health-care services; explanatory variables were socioeconomic status, education level, self-reported health status, age, gender, urban/rural location and social security affiliation.
There was no difference in health-care service access amongst people affiliated to contribution-based and subsidised regimes. However, financial constraints represented important obstacles for subsidised regime members and those having no affiliation. Contribution-based regime members had greater resources for continuing to receive attention. There was positive bias in using preventative services thereby favouring people having higher socioeconomic status.
Educational level, age and being affiliated to social security were the main factors explaining health-care service access. Gender, self-reported health status and geographical location were additional factors explaining preventative health-service access.
分析哥伦比亚安蒂奥基亚省医疗保健服务的可及性公平性。
评估了贫困群体和富裕群体以及有保险者和无保险者获得医疗保健服务的情况。估计了一个Logit模型,以分析获得治疗性和预防性医疗保健服务的主要决定因素;解释变量包括社会经济地位、教育水平、自我报告的健康状况、年龄、性别、城乡居住地以及社会保障参保情况。
参加缴费型和补贴型医保制度的人群在获得医疗保健服务方面没有差异。然而,经济限制对补贴型医保制度参保者和未参保者来说是重要障碍。缴费型医保制度参保者有更多资源继续接受治疗。在使用预防性服务方面存在正向偏差,因此有利于社会经济地位较高的人群。
教育水平、年龄和参加社会保障是解释医疗保健服务可及性的主要因素。性别、自我报告的健康状况和地理位置是解释预防性医疗服务可及性的其他因素。