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医疗使用中的社会经济不平等现象解析:来自伊朗的横断面分析

Explanation of Socio-economic Inequality in Medicine Use: A Cross-sectional Analysis from Iran.

作者信息

Torabipour Amin, Harati Khalilabad Touraj, Najafpour Zhila, Araban Marzieh, Vahedi Sajad

机构信息

Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Iran J Pharm Res. 2022 Dec 31;21(1):e129431. doi: 10.5812/ijpr-129431. eCollection 2022 Dec.

Abstract

BACKGROUND

Despite the favorable progress in the production of medicines, there is no significant access to these important health inputs among different socio-economic groups.

OBJECTIVES

This study aimed to measure and explain socio-economic inequality in prescribed and non-prescribed medicine use in Iran.

METHODS

Data were obtained from a recent household survey on health services in Iran conducted in 2016. The Erreygers concentration index (ECI) was used to measure socio-economic inequality in the use of prescribed and non-prescribed medicines. In addition, Decomposition analysis was conducted to explain socio-economic inequality.

RESULTS

The ECI revealed pro-rich socio-economic inequality in prescribed medicine use (ECI = 0.067, SE = 0.010), indicating that prescribed medicine use was concentrated on the better-offs. On the other hand, this index showed pro-poor inequality in non-prescribed medicine use (ECI = -0.064, SE = 0.009). Decomposition analysis showed that economic status and place of residence were the main determinants of socio-economic inequality in prescribing medicines. These factors and the number of health care needs explained the majority of socio-economic inequality in non-prescribed medicine use.

CONCLUSIONS

Despite previous positive beliefs, we found remarkable socio-economic inequality in the use of medicines in Iran. Facilitating access to pharmaceutical services for disadvantaged households and rural residents and promoting of national essential medicines list could be recommended against socio-economic inequality in the pharmaceutical market of Iran.

摘要

背景

尽管药品生产取得了良好进展,但不同社会经济群体在获取这些重要的医疗投入方面仍没有显著改善。

目的

本研究旨在衡量并解释伊朗处方药和非处方药使用中的社会经济不平等现象。

方法

数据来源于2016年伊朗近期进行的一项关于卫生服务的家庭调查。使用埃雷格斯浓度指数(ECI)来衡量处方药和非处方药使用中的社会经济不平等。此外,进行分解分析以解释社会经济不平等现象。

结果

ECI显示在处方药使用方面存在有利于富人的社会经济不平等(ECI = 0.067,标准误 = 0.010),这表明处方药的使用集中在较富裕人群。另一方面,该指数显示在非处方药使用方面存在有利于穷人的不平等(ECI = -0.064,标准误 = 0.009)。分解分析表明,经济状况和居住地是处方药使用中社会经济不平等的主要决定因素。这些因素以及医疗保健需求数量解释了非处方药使用中大部分社会经济不平等现象。

结论

尽管此前有积极的看法,但我们发现伊朗在药品使用方面存在显著的社会经济不平等。为了应对伊朗药品市场中的社会经济不平等现象,建议为弱势家庭和农村居民提供更容易获得药品服务的途径,并推广国家基本药物清单。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f011/10024324/d9fea096eaf0/ijpr-21-1-129431-i001.jpg

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