Fernández de la Hoz K, Leon D A
Sección de Epidemiología, Delegación Provincial de Sanidad, Subida dela Granja 10, 45071 Toledo, Spain.
Int J Epidemiol. 1996 Jun;25(3):593-603. doi: 10.1093/ije/25.3.593.
Socioeconomic differences have been described among the Spanish population. The purpose of this study was to investigate whether these variations are associated with differences in the use of health services between socioeconomic groups in Spain, taking into account self-perceived health as a measure of need.
Data were obtained from the 1987 Spanish National Health Survey. Socioeconomic position was measured by educational level and household income. Health care use was measured in two ways: prevalence of having consulted a doctor and of hospitalization over a defined period of time. Logistic regression models were used to analyse the relationship of interest.
After adjustment for age, an inverse association was seen between education and both consultation with a doctor and hospitalization. A very different picture emerged when the association between socioeconomic position and probability of health service use was examined according to level of self-perceived health. Among those with poor or very poor health, people in higher educational groups showed the greatest probability of consulting a doctor (odds ratio [OR] = 1.41, 95% confidence interval [CI] : 0.89-2.23) or of being hospitalized (OR = 1.79, 95% CI : 1.09-2.93) compared to those in the lower educational groups. The corresponding OR for household income were 1.02 (95% CI : 0.74-1.42) for consultation with a doctor and 1.67 (95% CI : 1.15-2.44) for hospitalization. These finding were broadly similar for men and women.
There is a socioeconomic variation in the pattern of use of health services in Spain in the sense that among those with poor self-perceived health, the more privileged have higher levels of health services use than others.
西班牙人群中存在社会经济差异。本研究旨在调查这些差异是否与西班牙社会经济群体之间卫生服务使用的差异相关，并将自我感知健康作为需求的一项衡量指标。
数据来自1987年西班牙全国健康调查。社会经济地位通过教育水平和家庭收入来衡量。卫生保健使用情况通过两种方式来衡量：在规定时间段内咨询医生的患病率和住院率。使用逻辑回归模型分析感兴趣的关系。
在对年龄进行调整后，教育与咨询医生和住院之间均呈现负相关。当根据自我感知健康水平来研究社会经济地位与卫生服务使用概率之间的关联时，出现了截然不同的情况。在健康状况较差或非常差的人群中，与低教育水平人群相比，高教育水平人群咨询医生（优势比[OR]=1.41，95%置信区间[CI]：0.89 - 2.23）或住院（OR = 1.79，95% CI：1.09 - 2.93）的概率最高。家庭收入方面，咨询医生的相应OR为1.02（95% CI：0.74 - 1.42），住院的相应OR为1.67（95% CI：1.15 - 2.44）。这些发现男性和女性大致相似。
在西班牙，卫生服务使用模式存在社会经济差异，即自我感知健康较差的人群中，享有更多特权的人群比其他人的卫生服务使用水平更高。
