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农村地区残疾人获得医疗服务的资金障碍:以伊朗为例。

Barriers to financial access of disabled people to health services in rural areas: A case study of Iran.

作者信息

Shams Lida, Nasiri Taha, Darvish Tahere, Hosseini-Shokouh Sayyed-Morteza, Amiri Mohammad Meskarpour

机构信息

Department of Health Policy and Management, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

出版信息

J Educ Health Promot. 2024 Mar 28;13:89. doi: 10.4103/jehp.jehp_63_23. eCollection 2024.

Abstract

BACKGROUND

People with disabilities (PWDs) account for a significant percentage of the world's population, with a higher prevalence in less developed countries. Access to healthcare services is the main component of health systems performance, with lower access for PWDs living in rural areas. The current study aimed to investigate PWD's access to healthcare services in rural areas of Iran and, secondly, factors that contribute to this issue.

MATERIALS AND METHODS

Following a cross-sectional design, the current descriptive-analytical study is performed in the north of Iran. Using the quota sampling technique, 471 PWDs were recruited. Data were collected using a valid and reliable questionnaire, covering three dimensions of access, by face-to-face interview. Data analysis was administered using central tendency indicators and multiple regression by SPSS version 17. Statistical significance was considered when the value <0.05.

RESULTS

The mean score of PWD's access to healthcare services for dimensions of utilization, availability, and affordability was 8.91 (±6.86), 14.54 (±2.3), and 51.91 (±8.78), indicating very low, low, and moderate levels of access. All three regression models were significant ( < 0.05), and variables of gender, age, marital status, education level, residence status, the income of the household head, receiving financial aid, and house area showed a significant effect ( < 0.05).

CONCLUSION

This study demonstrated the seriousness of paying attention to PWD's financial access to healthcare services, particularly in rural areas of Iran. Hence, policymakers should better focus on this problem, mainly regarding accessibility and utilization and factors that result in inequalities.

摘要

背景

残疾人占世界人口的很大比例,在欠发达国家患病率更高。获得医疗保健服务是卫生系统绩效的主要组成部分,生活在农村地区的残疾人获得服务的机会较低。本研究旨在调查伊朗农村地区残疾人获得医疗保健服务的情况,其次是导致这一问题的因素。

材料与方法

采用横断面设计,在伊朗北部进行了这项描述性分析研究。使用配额抽样技术,招募了471名残疾人。通过面对面访谈,使用有效且可靠的问卷收集数据,问卷涵盖获得服务的三个维度。使用集中趋势指标和SPSS 17版进行多元回归分析数据。当P值<0.05时,认为具有统计学意义。

结果

残疾人在利用、可及性和可承受性维度上获得医疗保健服务的平均得分分别为8.91(±6.86)、14.54(±2.3)和51.91(±8.78),表明获得服务的水平非常低、低和中等。所有三个回归模型均具有统计学意义(P<0.05),性别、年龄、婚姻状况、教育水平、居住状况、户主收入、获得经济援助和房屋面积等变量显示出显著影响(P<0.05)。

结论

本研究表明关注残疾人获得医疗保健服务的经济状况的重要性,特别是在伊朗农村地区。因此,政策制定者应更好地关注这个问题,主要涉及可及性、利用情况以及导致不平等的因素。

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