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医疗保健未满足需求的原因:社会资本和社会支持在部分欧盟西部国家中的作用

Reasons for unmet needs for health care: the role of social capital and social support in some western EU countries.

作者信息

Fiorillo Damiano

机构信息

Department of Business and Economics, Parthenope University of Naples, Via Generale Parisi, 13, 80132, Naples, Italy.

出版信息

Int J Health Econ Manag. 2020 Mar;20(1):79-98. doi: 10.1007/s10754-019-09271-0. Epub 2019 Jul 11.

Abstract

This paper focuses on the demand side factors that determine access to health care and analyses the issues of unmet needs for health care and the reasons thereof in western EU countries. A probit model is estimated from a sample of the whole population, accounting for the possibility of individual selection in unmet needs for health care (UN) (selection equation). Expanded probit models (including the inverse Mills ratio) are then used on the reasons for unmet needs (RUN) with social capital and social support as determinants and using the European Union Statistics on Income and Living Conditions dataset from 2006. In the RUN equations, the findings show that females, large households, people with low income and financial constraints, the unemployed and those in poor health have a higher probability of declaring unmet needs due to economic costs. Additionally, people in tertiary education, those with high income and the employed have a higher probability of not visiting a doctor when needed due to time constraints. Furthermore, the frequency of contact with friends and the ability to ask for help are correlated with a lower probability of unmet needs due to economic costs, while the frequency of contact with relatives is correlated with a lower probability of unmet needs due to time constraints and distance. However, the ability to ask for help is also correlated with a higher probability of not having medical care due to time constraints and the wait-and-see approach.

摘要

本文聚焦于决定医疗保健可及性的需求侧因素,并分析了欧盟西部国家医疗保健未满足需求的问题及其原因。我们从全体人口样本中估计了一个概率模型,考虑到个人在医疗保健未满足需求(UN)方面进行选择的可能性(选择方程)。然后,我们使用扩展概率模型(包括逆米尔斯比率),以社会资本和社会支持作为决定因素,并利用2006年欧盟收入和生活条件统计数据集,来分析未满足需求的原因(RUN)。在RUN方程中,研究结果表明,女性、大家庭、低收入和有经济困难的人、失业者以及健康状况不佳的人,因经济成本而宣称有未满足需求的概率更高。此外,受过高等教育的人、高收入者和就业者,因时间限制而在需要时不看医生的概率更高。此外,与朋友联系的频率以及寻求帮助的能力,与因经济成本导致未满足需求的概率较低相关,而与亲戚联系的频率,与因时间限制和距离导致未满足需求的概率较低相关。然而,寻求帮助的能力也与因时间限制和观望态度而没有接受医疗护理的概率较高相关。

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