Bourne Paul A, Eldemire-Shearer Denise, Paul Tomlin J, Lagrenade Janet, Charles Christopher Ad
Department of Community Health and Psychiatry, Faculty of Medical Sciences, University of the West Indies, Mona, Kingston, Jamaica;
Patient Relat Outcome Meas. 2010 Jul;1:81-91. doi: 10.2147/PROM.S11868. Epub 2010 Sep 1.
To assess trends in the use of private and public health care services among Jamaicans over a 15-year period (1991-2007).
Statistics on the use of health care services were taken from the Jamaica Survey of Living Conditions (JSLC) for the 15-year period 1993 to 2007. Use of hospital services were represented in income quintiles and compared for private and public facilities. The difference in percentage use between public and private was compared by quintiles over the period and the variability in those differentials assessed.
This study highlights the increasing use of private services by increasing wealth, exaggerated for the wealthiest quintile. There is a widening of the differences in utilization between public and private centers as income level increases (P < 0.001).
Internal and external economic conditions influence the use of private and public health care services in Jamaica. Although the relative increase in the cost (to the user) of public health care is more than that for private health care, the actual cost to use the public health care system is still significantly cheaper than using the private system. Lower income health care users tend to take the lesser cost option.
评估牙买加人在15年期间（1991 - 2007年）使用私立和公立医疗服务的趋势。
1993年至2007年这15年期间的医疗服务使用统计数据取自牙买加生活条件调查（JSLC）。医院服务的使用情况按收入五分位数呈现，并对私立和公立机构进行比较。在这一期间，按五分位数比较公立和私立机构使用百分比的差异，并评估这些差异的变异性。
本研究突出显示，随着财富增加，私立服务的使用也在增加，这在最富有的五分位数人群中表现得更为明显。随着收入水平的提高，公立和私立医疗中心的利用率差异不断扩大（P < 0.001）。
内部和外部经济状况影响牙买加私立和公立医疗服务的使用。虽然公立医疗服务（对使用者而言）成本的相对增幅大于私立医疗服务，但使用公立医疗系统的实际成本仍明显低于使用私立系统。低收入的医疗服务使用者往往选择成本较低的选项。
