Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Sabzevar University of Medical Sciences, Sabzevar, Iran.
BMC Health Serv Res. 2022 Nov 29;22(1):1449. doi: 10.1186/s12913-022-08811-8.
Persons with disabilities (PWD) generally experience various barriers in using health care compared to the general population, and these problems are more worsened for those with disabilities in lower socioeconomic status. The study aimed to estimate socioeconomic inequality in using rehabilitation services (URS) in adults with disabilities in Iran.
This cross-sectional study was conducted at a national level in Iran. 786 PWD (aged 18 years and older) participated in the study between September and December 2020. Socioeconomic-related inequality in URS was estimated by the Concentration Index (C). The C was decomposed to identify factors explaining the variability within the socioeconomic inequality in URS.
In the present study 8.10% (N = 61) of the study population used rehabilitation services during the past three months. In this study, the value of the C was estimated 0.25 (p-value = 0.025) that shows URS was unequally distributed, and concentrated among the higher SES groups. The results of decomposition analysis indicated that the wealth index was the largest contributor (94.22%) to the observed socioeconomic inequalities in URS among PWD. Following the wealth index, Age and marital status were the major contributors to the unequal distribution of URS among the study population.
Our findings revealed that socioeconomic inequality in using rehabilitation services was concentrated among well-off PWD. Accordingly, rehabilitation financing through appropriate mechanisms for individuals with low SES is suggested.
与一般人群相比，残疾人（PWD）在使用医疗保健方面普遍存在各种障碍，而社会经济地位较低的残疾人的这些问题更为严重。本研究旨在估计伊朗残疾成年人使用康复服务（URS）的社会经济不平等情况。
本横断面研究在伊朗全国范围内进行。2020 年 9 月至 12 月期间，786 名残疾成年人（年龄在 18 岁及以上）参与了这项研究。使用集中指数（C）来估计 URS 方面的社会经济相关不平等。对 C 进行分解，以确定解释 URS 社会经济不平等内部变异性的因素。
在本研究中，8.10%（N=61）的研究人群在过去三个月中使用了康复服务。本研究中，C 的值估计为 0.25（p 值=0.025），表明 URS 分布不均，集中在较高社会经济地位群体中。分解分析的结果表明，财富指数是 PWD 使用 URS 方面观察到的社会经济不平等的最大贡献者（94.22%）。其次是年龄和婚姻状况，是 URS 在研究人群中分布不均的主要因素。
我们的研究结果表明，使用康复服务的社会经济不平等集中在富裕的 PWD 中。因此，建议通过适当的机制为社会经济地位较低的个人提供康复资金。
