The effect of education level on intensity of using medical care by women of reproductive age

Abstract

The education is often considered as one of the basic social determinants of population health, but its impact on the need for medical care is to be studied. The purpose of the study is to analyze effect of education as health social determinant on intensity of medical care consumption by women of reproductive age. The sampling consisted of 566 non-pregnant women aged 18-49 years residing in Samara and being monitored in municipal antenatal clinics. The level of territorial accessibility of medical care for all women participating in the study did not differ reliably. The data was obtained using anonymous survey with adapted questionnaire "Research of social determinants of health". The first comparison group included 306 women with higher or incomplete higher education (high educational status). The second comparison group included 260 women with secondary or specialized secondary education (lower educational status). Each of the groups was divided into four subgroups based on age characteristic (18-25, 26-34, 35-42, 43-49 years). In the group of women with a high educational status, volume of consumption of out-patient medical care were higher and decreasing of health self-rating was accompanied by decreased rate of visits to ambulatory physicians (r = -0.67). Whereas in women with low educational status, decreasing of health self-rating is accompanied by decreased rates of visits to ambulatory physicians (r=0.5). With age increased, volume of out-patient medical care consumption in group of women with high educational status increases, while in group of women with low educational status this volume decreases. The lower rate of out-patient medical care consumption results in increasing of volume of in-patient medical care consumption in the group of women with low educational status. Despite the same increasing dynamics of volume of consumption of in-patient medical care in women with different educational statuses, gain rate of demand is significantly higher in group of women with low educational status (1.42% versus 2.54% of annual gain in consumption). More significant increase in consumption of emergency medical care was observed in group of women with low educational status (annual increase 3% versus 0.22%).