Peltzer Karl, Williams Jennifer Stewart, Kowal Paul, Negin Joel, Snodgrass James Josh, Yawson Alfred, Minicuci Nadia, Thiele Liz, Phaswana-Mafuya Nancy, Biritwum Richard Berko, Naidoo Nirmala, Chatterji Somnath
Human Sciences Research Council, Pretoria, South Africa; Department of Psychology, University of the Free State, Bloemfontein, South Africa; ASEAN Institute for Health Development, Mahidol University, Nakhon Pathom, Thailand;
Department Public Health and Clinical Medicine Epidemiology, Global Health Umeå University, Umeå, Sweden; Research Centre for Gender, Health & Ageing, University of Newcastle, Newcastle, Australia.
Glob Health Action. 2014 Oct 31;7:25314. doi: 10.3402/gha.v7.25314. eCollection 2014.
The achievement of universal health coverage (UHC) in emerging economies is a high priority within the global community. This timely study uses standardized national population data collected from adults aged 50 and older in China, Ghana, India, Mexico, the Russian Federation, and South Africa. The objective is to describe health care utilization and measure association between inpatient and outpatient service use and patient characteristics in these six low- and middle-income countries.
Secondary analysis of data from the World Health Organization's Study on global AGEing and adult health Wave 1 was undertaken. Country samples are compared by socio-demographic characteristics, type of health care, and reasons for use. Logistic regressions describe association between socio-demographic and health factors and inpatient and outpatient service use.
In the pooled multi-country sample of over 26,000 adults aged 50-plus, who reported getting health care the last time it was needed, almost 80% of men and women received inpatient or outpatient care, or both. Roughly 30% of men and women in the Russian Federation used inpatient services in the previous 3 years and 90% of men and women in India used outpatient services in the past year. In China, public hospitals were the most frequently used service type for 52% of men and 51% of women. Multivariable regression showed that, compared with men, women were less likely to use inpatient services and more likely to use outpatient services. Respondents with two or more chronic conditions were almost three times as likely to use inpatient services and twice as likely to use outpatient services compared with respondents with no reported chronic conditions.
This study provides a basis for further investigation of country-specific responses to UHC.
新兴经济体实现全民健康覆盖（UHC）是国际社会的一项高度优先事项。这项及时开展的研究使用了从中国、加纳、印度、墨西哥、俄罗斯联邦和南非50岁及以上成年人中收集的标准化国家人口数据。目的是描述这六个低收入和中等收入国家的医疗保健利用情况，并衡量住院和门诊服务使用与患者特征之间的关联。
对世界卫生组织全球老龄化与成人健康研究第一轮的数据进行二次分析。按社会人口特征、医疗保健类型和使用原因对各国样本进行比较。逻辑回归描述了社会人口和健康因素与住院和门诊服务使用之间的关联。
在超过26000名50岁及以上成年人的多国汇总样本中，那些报告在最后一次需要医疗保健时获得了医疗服务的人，近80%的男性和女性接受了住院或门诊护理，或两者都接受了。在俄罗斯联邦，大约30%的男性和女性在过去3年中使用过住院服务，在印度，90%的男性和女性在过去一年中使用过门诊服务。在中国，公立医院是52%的男性和51%的女性最常使用的服务类型。多变量回归显示，与男性相比，女性使用住院服务的可能性较小，使用门诊服务的可能性较大。与未报告慢性病的受访者相比，患有两种或更多慢性病的受访者使用住院服务的可能性几乎是其三倍，使用门诊服务的可能性是其两倍。
本研究为进一步调查各国对全民健康覆盖的具体应对措施提供了依据。
