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克罗地亚的医疗保健需求、利用情况及障碍——地区和城乡差异

Health care needs, utilization and barriers in croatia--regional and urban-rural differences.

作者信息

Pristas Ivan, Bilić Marinko, Pristas Irina, Voncina Luka, Krcmar Nevenka, Polasek Ozren, Stevanović Ranko

机构信息

Croatian National Institute of Public Health, Zagreb, Croatia.

出版信息

Coll Antropol. 2009 Apr;33 Suppl 1:121-30.

Abstract

Even the most socially aware countries in the World have noticed the gap increase between the poorest and the richest population groups. The purpose of this study was to investigate the presence of inequity and to identify main barriers for equitable health care utilization by economic status, region and area of living, controlled for health needs in the Croatian adult population. The data from the Croatian Adult Health Survey 2003 were used in this study. The results show that among the respondents with higher health needs, those with economic status above average had higher proportion of regular annual general practitioner and medical specialist visits. In contrast, highly frequent visits to physician were more common in respondents who were below average economic status. Economically worse-off women, regardless on their health care needs reported gynecologist visits less regularly than the better-off women. Long waiting and the large distance from the health care facilities were the most commonly reported barriers in health care utilization. High expenses were present as the main barrier at dentist and inpatient health services utilization. Suburban and rural settlements were more burdened with long distance from the health care facilities and high expenses for all health services, aggravated by the long waiting time for visits to GP. Respondents from the urban settings reported long waiting time and unkindness of the health personnel as the main barriers. The results of this study clearly show the main barriers in the equitable health care delivery to Croatia population from the health care users perspective.

摘要

即使是世界上最具社会意识的国家也注意到了最贫困和最富裕人群之间差距的扩大。本研究的目的是调查不平等现象的存在,并确定按经济状况、地区和居住区域划分的公平医疗保健利用的主要障碍,同时控制克罗地亚成年人口的健康需求。本研究使用了2003年克罗地亚成人健康调查的数据。结果表明,在健康需求较高的受访者中,经济状况高于平均水平的人每年定期看全科医生和专科医生的比例更高。相比之下,经济状况低于平均水平的受访者中,频繁看医生的情况更为常见。经济状况较差的女性,无论其医疗保健需求如何,报告看妇科医生的频率都低于经济状况较好的女性。长时间等待和距离医疗保健设施较远是医疗保健利用中最常报告的障碍。高费用是牙科和住院医疗服务利用的主要障碍。郊区和农村定居点因距离医疗保健设施较远以及所有医疗服务费用较高而负担更重,看全科医生的长时间等待加剧了这种情况。城市地区的受访者报告称,长时间等待和医护人员态度不友好是主要障碍。本研究结果清楚地从医疗保健使用者的角度显示了克罗地亚人口公平医疗保健提供中的主要障碍。

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