Cooper H, Smaje C, Arber S
Department of Sociology, University of Surrey, Guildford, Surrey GU2 5XH.
BMJ. 1998 Oct 17;317(7165):1047-51. doi: 10.1136/bmj.317.7165.1047.
To assess whether equity is achieved in use of general practitioner, outpatient, and inpatient services by children and young people according to their ethnic group and socioeconomic background.
Secondary analysis of the British general household survey, 1991-94.
20 473 children and young people aged between 0 and 19 years.
Consultations with a general practitioner within a two week period, outpatient attendances within a three month period, and inpatient stays during the past year.
There were no significant class differences in the use of health services by children and young people, and there was little evidence of variation in use of health services according to housing tenure and parental work status. South Asian children and young people used general practitioner services more than any other ethnic group after controlling for socioeconomic background and perceived health status, but the use of hospital outpatient and inpatient services was significantly lower for children and young people from all minority ethnic groups compared with the white population.
Our results differ from previous studies, which have reported significant class differences in use of health services for other age groups. We found no evidence that children and young people's use of health services varied according to their socioeconomic status, suggesting that equity has been achieved. A child or young person's ethnic origin, however, was clearly associated with use of general practitioner and hospital services, which could imply that children and young people from minority ethnic groups receive a poorer quality of health care than other children and young people.
根据儿童和青少年的种族及社会经济背景，评估在使用全科医生、门诊和住院服务方面是否实现了公平。
对1991 - 1994年英国一般家庭调查进行二次分析。
20473名年龄在0至19岁之间的儿童和青少年。
两周内与全科医生的会诊次数、三个月内的门诊就诊次数以及过去一年中的住院天数。
儿童和青少年在使用卫生服务方面不存在显著的阶层差异，并且几乎没有证据表明根据住房保有情况和父母工作状况，卫生服务的使用存在差异。在控制了社会经济背景和自我感知的健康状况后，南亚儿童和青少年使用全科医生服务的频率高于其他任何种族群体，但与白人相比，所有少数族裔儿童和青少年的医院门诊和住院服务使用率显著较低。
我们的结果与之前的研究不同，之前的研究报告了其他年龄组在使用卫生服务方面存在显著的阶层差异。我们没有发现证据表明儿童和青少年使用卫生服务的情况因其社会经济地位而有所不同，这表明已经实现了公平。然而，儿童或青少年的种族出身显然与全科医生和医院服务的使用有关，这可能意味着少数族裔儿童和青少年获得的医疗保健质量比其他儿童和青少年差。
