Krasnik A, Hansen E, Keiding N, Sawitz A
Department of Health Services Research, University of Copenhagen.
Dan Med Bull. 1997 Nov;44(5):542-6.
The study was undertaken to identify determinants of health services' utilization related to organizational characteristics of the health services, social characteristics of the community, and health and socio-demographic characteristics of the population. We used a follow-up design involving a time dimension of 12 months. A cohort of 3000 50-year old males and females were randomly selected from an urban county near Copenhagen and a rural county in Western Jutland and 65% agreed to participate. Data were collected through: 1) mailed questionnaires to the participants every three months, 2) a mailed questionnaire to all general practitioners in the counties, and 3) the Health Insurance Register. Data were analyzed by multivariate logistic regression analysis. Utilization of health services was found to be strongly associated with gender and health characteristics, especially with respect to functional status and chronic diseases. Health service characteristics, demographic and psycho-social factors had very little impact on utilization patterns. The utilization of publicly financed health services was found to be determined by health needs rather than by social, psychological and organizational factors, indicating geographical and social equity in the access to the Danish health services.
该研究旨在确定与卫生服务的组织特征、社区的社会特征以及人群的健康和社会人口特征相关的卫生服务利用的决定因素。我们采用了一种包含12个月时间维度的随访设计。从哥本哈根附近的一个城市县和日德兰半岛西部的一个农村县随机抽取了3000名50岁的男性和女性作为队列,65%的人同意参与。数据通过以下方式收集:1)每三个月向参与者邮寄问卷;2)向各县的所有全科医生邮寄问卷;3)医疗保险登记册。通过多变量逻辑回归分析对数据进行分析。发现卫生服务的利用与性别和健康特征密切相关,特别是在功能状态和慢性病方面。卫生服务特征、人口统计学和心理社会因素对利用模式的影响很小。发现公共资助的卫生服务的利用取决于健康需求,而非社会、心理和组织因素,这表明在获得丹麦卫生服务方面存在地理和社会公平性。