Health Serv Res. 2014 Jun;49(3):950-70. doi: 10.1111/1475-6773.12128.
To provide new evidence on whether and how patterns of health care utilization deviate from horizontal equity in a country with a universal and egalitarian public health care system: Italy.
Secondary analysis of data from the Health Conditions and Health Care Utilization Survey 2005, conducted by the Italian National Institute of Statistics on a probability sample of the noninstitutionalized Italian population.
Using multilevel logistic regression, we investigated how the probability of utilizing five health care services varies among individuals with equal health status but different SES.
DATA COLLECTION/EXTRACTION: Respondents aged 18 or older at the interview time (n = 103,651).
Overall, we found that use of primary care is inequitable in favor of the less well-off, hospitalization is equitable, and use of outpatient specialist care, basic medical tests, and diagnostic services is inequitable in favor of the well-off. Stratifying the analysis by health status, however, we found that the degree of inequity varies according to health status.
Despite its universal and egalitarian public health care system, Italy exhibits a significant degree of SES-related horizontal inequity in health services utilization.
为一个具有普遍和平等公共医疗保健系统的国家（意大利）提供有关医疗保健利用模式是否以及如何偏离横向公平性的新证据。
意大利国家统计局（ISTAT）对非机构化的意大利人口进行概率抽样，开展了 2005 年健康状况和医疗保健利用调查（Health Conditions and Health Care Utilization Survey 2005），本文对其数据进行二次分析。
利用多水平逻辑回归分析，我们调查了具有相同健康状况但不同 SES 的个体之间利用五种医疗保健服务的概率如何变化。
资料收集/提取：接受采访时年龄在 18 岁及以上的受访者（n=103651）。
总体而言，我们发现初级保健的利用不公平，有利于经济条件较差的人群；住院治疗则是公平的；而专科门诊、基本医疗检查和诊断服务的利用不公平，有利于经济条件较好的人群。但是，按健康状况对分析进行分层后，我们发现根据健康状况的不同，不公平的程度也有所不同。
尽管意大利拥有普遍和平等的公共医疗保健系统，但在医疗服务利用方面，社会经济地位相关的横向不公平程度仍然很高。
