López Nicolás Angel, Ramos Parreño José María
Departamento de Economía, Universidad Politécnica de Cartagena, Cartagena, España.
Gac Sanit. 2009 Dec;23 Suppl 1:12-8. doi: 10.1016/j.gaceta.2009.04.007. Epub 2009 Nov 26.
To analyze the patterns of utilisation for three types of public health services (outpatient specialist visits, emergency visits and hospitalisations) in the Comunidad Autónoma de la Región de Murcia. We examine the differences between the average rates of utilization of these services among natives and non-Spanish immigrants, and whether these differences are due to differences in demographic structure, or to different behaviour between these groups.
We use econometric models for utilisation to exploit administrative records on health care utilisation and the well established Oaxaca decomposition method. This splits average rates of utilisation and/or average health expenditure into two components: the first one stands for the part of the difference that can be attributed to differential patterns of behaviour among the two groups; the second one represents the part of the difference in average expenditure that can be attributed to the fact that average demographic characteristics among both groups differ.
The rates of use of outpatient specialist visits, emergencies and hospital nights by the native population are greater than the corresponding rates for the immigrant population. For individuals aged between 20 to 40 years old, the utilisation rates of African and Latin-American females are higher than those for native females. The average health expenditure of native males is greater than that of immigrants. The difference is mainly due to different demographic features among the native and immigrant populations, except for the <
In this paper we show that the remarkable differences in the age-gender balance among different (in terms of nationality) groups of insured residents in Murcia has a considerable effect on consumption of health services and therefore on the average health care expenditure attributable to these groups.
分析穆尔西亚自治区三种公共卫生服务（门诊专科就诊、急诊就诊和住院治疗）的利用模式。我们研究了本地人和非西班牙移民在这些服务的平均利用率之间的差异，以及这些差异是由于人口结构的不同，还是由于这些群体之间的行为差异。
我们使用利用率的计量经济学模型来利用医疗保健利用的行政记录和成熟的瓦哈卡分解方法。这将平均利用率和/或平均医疗支出分为两个部分：第一部分代表可归因于两组之间不同行为模式的差异部分；第二部分代表平均支出差异中可归因于两组平均人口特征不同这一事实的部分。
本地人口的门诊专科就诊、急诊和住院天数的使用率高于移民人口的相应使用率。对于20至40岁的个体，非洲和拉丁美洲女性的利用率高于本地女性。本地男性的平均医疗支出高于移民。除了“欧洲其他地区”群体，其个体表现出不同的行为外，差异主要是由于本地和移民人口之间不同的人口特征。事实上，在20至40岁年龄组中，本地女性的平均医疗支出与拉丁美洲女性相等，而拉丁美洲女性的平均医疗支出又低于非洲女性。
在本文中，我们表明穆尔西亚不同国籍的参保居民群体在年龄-性别平衡上的显著差异对卫生服务消费有相当大的影响，因此对这些群体的平均医疗保健支出也有相当大的影响。
