Geitona Mary, Zavras Dimitrios, Kyriopoulos John
Department of Economics, University of Thessaly, Volos, Greece.
Eur J Gen Pract. 2007;13(3):144-50. doi: 10.1080/13814780701541340.
To explore factors influencing the utilization of primary and secondary healthcare in Greece.
A national, geographically stratified sample was randomly selected. From November 2001 to March 2002, 5000 questionnaires were mailed, 4427 were actually received, and 1819 were completed and returned (response rate 41%). The questionnaire investigated respondents' characteristics and their health services utilization. A number of potential utilization determinants were explored, such as region, gender, age, education, income, insurance coverage, number of family members, self-rated health status, country of birth, and parents' country of birth.
The utilization of primary healthcare services depended on self-rated health status, age, income, gender, and region. Individuals with moderate and poor self-rated health, older people, women, and residents of the region of Epirus showed increased utilization of primary healthcare services. Income was a factor affecting the utilization of primary healthcare only at lower income levels. The frequency of visits for primary healthcare was negatively correlated with self-rated health status and increased as self-evaluation of health status worsened. Hospitalization was associated with self-rated health and insurance coverage for primary healthcare. Individuals with better self-rated health status, as well as those who were covered by health insurance for primary care, showed decreased hospital care utilization. The frequency of hospitalization depended on region and lower evaluations of health status.
The findings of our research are encouraging, since they suggest that the utilization of health services in Greece is mostly determined by health status rather than other socioeconomic factors. It is believed that similar studies should be conducted in the country, since they can improve health service planning and reinforce decision-making towards healthcare resource allocation according to healthcare needs.
探讨影响希腊初级和二级医疗保健利用的因素。
随机抽取一个全国性的、按地理分层的样本。2001年11月至2002年3月，邮寄了5000份问卷，实际收到4427份，其中1819份填写并返回（回复率41%）。问卷调查了受访者的特征及其医疗服务利用情况。探讨了一些潜在的利用决定因素，如地区、性别、年龄、教育程度、收入、保险覆盖范围、家庭成员数量、自评健康状况、出生地以及父母的出生地。
初级医疗保健服务的利用取决于自评健康状况、年龄、收入、性别和地区。自评健康状况为中等和较差的个体、老年人、女性以及伊庇鲁斯地区的居民，初级医疗保健服务的利用率较高。收入仅在低收入水平时是影响初级医疗保健利用的一个因素。初级医疗保健就诊频率与自评健康状况呈负相关，且随着对健康状况自评变差而增加。住院与自评健康状况和初级医疗保健保险覆盖范围有关。自评健康状况较好的个体以及参加初级医疗保健保险的个体，住院护理利用率较低。住院频率取决于地区和对健康状况的较低评价。
我们的研究结果令人鼓舞，因为它们表明希腊医疗服务的利用主要由健康状况而非其他社会经济因素决定。人们认为该国应开展类似研究，因为这些研究可以改善医疗服务规划，并加强根据医疗需求进行医疗资源分配的决策。
