伊朗的社会经济地位与对公共医疗体系的满意度
Socioeconomic Status and Satisfaction with Public Healthcare System in Iran.
作者信息
Maharlouei Najmeh, Akbari Mojtaba, Akbari Maryam, Lankarani Kamran B
机构信息
Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Epidemiology, School of Health and Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran.
出版信息
Int J Community Based Nurs Midwifery. 2017 Jan;5(1):22-29.
BACKGROUND
The users' satisfaction is a method for evaluating the efficacy of healthcare system. We aimed to evaluate the association between the users' socioeconomic status (SES) and satisfaction with the healthcare system in Shiraz, Iran.
METHODS
This cross-sectional study was conducted from December, 2013 to March, 2014, in Shiraz, Iran. 3400 households were recruited by multi-stage cluster random sampling. Information about demographic, insurance status, and users' satisfaction was derived from face-to-face interviews. Satisfaction with healthcare system was assessed by using 5-point Likert scale statements, which ranged from "very dissatisfied" to "very satisfied". All statistical analyses were performed using SPSS-21.
RESULTS
Overall, 1.6% (55) of the respondents were very satisfied, while 6% (203) were very dissatisfied with healthcare system. Participants were classified into high SES (26.3%), middle SES (47.9%) and low SES (25.8%). It was discovered that the better the SES, the more frequent were the respondents dissatisfied with healthcare system (P<0.001). Also, dissatisfied respondents were significantly older (P=0.036). Moreover, women were more dissatisfied with healthcare system (P=0.005). Also, dissatisfied respondents had significantly a higher level of education than satisfied ones (P<0.001). Furthermore, logistic regression revealed that age (P=0.04), marital status (P=0.01), insurance status (P<0.001), SES (P<0.001), and having supplemental insurance (P=0.02) were determinant factors of satisfaction with healthcare system.
CONCLUSION
This study demonstrated that users' sex, age, educational level, and SES were related to dissatisfaction with healthcare system. Meanwhile, clients' age, SES, insurance status and marital status were recognized as determinant factors.
背景
用户满意度是评估医疗保健系统效能的一种方法。我们旨在评估伊朗设拉子地区用户的社会经济地位（SES）与对医疗保健系统满意度之间的关联。
方法
这项横断面研究于2013年12月至2014年3月在伊朗设拉子进行。通过多阶段整群随机抽样招募了3400户家庭。有关人口统计学、保险状况和用户满意度的信息来自面对面访谈。使用5点李克特量表陈述来评估对医疗保健系统的满意度，范围从“非常不满意”到“非常满意”。所有统计分析均使用SPSS - 21进行。
结果
总体而言，1.6%（55人）的受访者对医疗保健系统非常满意，而6%（203人）非常不满意。参与者被分为高社会经济地位组（26.3%）、中社会经济地位组（47.9%）和低社会经济地位组（25.8%）。研究发现，社会经济地位越高，受访者对医疗保健系统不满意的频率越高（P<0.001）。此外，不满意的受访者年龄显著更大（P = 0.036）。而且，女性对医疗保健系统更不满意（P = 0.005）。此外，不满意的受访者受教育程度明显高于满意的受访者（P<0.001）。此外，逻辑回归显示年龄（P = 0.04）、婚姻状况（P = 0.01）、保险状况（P<0.001）、社会经济地位（P<0.001）和拥有补充保险（P = 0.02）是对医疗保健系统满意度的决定因素。
结论
本研究表明，用户的性别、年龄、教育水平和社会经济地位与对医疗保健系统的不满意有关。同时，客户的年龄、社会经济地位、保险状况和婚姻状况被认为是决定因素。
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