Birch Stephen, Haas Marion, Savage Elizabeth, Van Gool Kees
Centre for Health Economics Research and Evaluation, University of Technology Sydney, PO Box 123 Broadway, Sydney, Australia.
Aust New Zealand Health Policy. 2007 Jun 5;4:12. doi: 10.1186/1743-8462-4-12.
Many jurisdictions have used public funding of health care to reduce or remove price at the point of delivery of services. Whilst this reduces an important barrier to accessing care, it does nothing to discriminate between groups considered to have greater or fewer needs. In this paper, we consider whether active targeted recruitment, in addition to offering a 'free' service, is associated with a reduction in social inequalities in self-reported utilization of the breast screening services in NSW, Australia.
Using the 1997 and 1998 NSW Health Surveys we estimated probit models on the probability of having had a screening mammogram in the last two years for all women aged 40-79. The models examined the relative importance of socio-economic and geographic factors in predicting screening behaviour in three different needs groups - where needs were defined on the basis of a woman's age.
We find that women in higher socio-economic groups are more likely to have been screened than those in lower groups for all age groups. However, the socio-economic effect is significantly less among women who were in the actively targeted age group.
This indicates that recruitment and follow-up was associated with a modest reduction in social inequalities in utilisation although significant income differences remain.
许多司法管辖区利用医疗保健的公共资金来降低或消除服务提供点的价格。虽然这减少了获得护理的一个重要障碍，但对于区分被认为需求较多或较少的群体却毫无作用。在本文中，我们探讨除了提供“免费”服务之外，积极的目标招募是否与澳大利亚新南威尔士州自我报告的乳房筛查服务利用率方面的社会不平等现象减少有关。
利用1997年和1998年新南威尔士州健康调查，我们针对所有40 - 79岁女性在过去两年内进行乳房X光筛查的概率估计了概率模型。这些模型考察了社会经济和地理因素在预测三个不同需求群体（需求根据女性年龄定义）的筛查行为方面的相对重要性。
我们发现，在所有年龄组中，社会经济地位较高群体的女性比地位较低群体的女性更有可能接受筛查。然而，在积极目标招募年龄组的女性中，社会经济效应明显较小。
这表明招募和后续跟进与利用率方面的社会不平等现象适度减少有关，尽管显著的收入差异仍然存在。
