Equity In Health Care Utilization Research Articles

Gender and the utilisation of health services in the Ashanti Region, Ghana

The survey seeks to structure a model for gender-based health services utilisation for the Ashanti Region of Ghana, and in addition, recommend intervention measures to ensure gender equity in the utilisation of health services. A sample size of 650 covered over 3108 houses, and the main research instruments were the questionnaire and formal interview. A multiple regression model is used for the analysis of the relationship between the complex independent variables and utilisation by gender. Results show that although females have a greater need for health services than males, they do not utilise health services as much. Secondly, whereas quality of service, health status, service cost and education have greater effect on male utilisation than females, distance and income have higher impact on female utilisation. It is recommended that, to ensure equity in health care utilisation, females be empowered through increased access to formal education and sustainable income opportunities. The introduction of a national health insurance scheme is also recommended to ensure adequate access by both sexes.

Equity in the delivery of health care in Europe and the US

This paper presents a comparison of horizontal equity in health care utilization in 10 European countries and the US. It does not only extend previous work by using more recent data from a larger set of countries, but also uses new methods and presents disaggregated results by various types of care. In all countries, the lower-income groups are more intensive users of the health care system. But after indirect standardization for need differences, there is little or no evidence of significant inequity in the delivery of health care overall, though in half of the countries, significant pro-rich inequity emerges for physician contacts. This seems to be due mainly to a higher use of medical specialist services by higher-income groups and a higher use of GP care among lower-income groups. These findings appear to be fairly general and emerge in countries with very diverse characteristics regarding access and provider incentives.

Socioeconomic inequity in health care: A study of services utilization in Curaçao

The aim of this study is to examine whether there is socioeconomic equity in health care utilization in Curaçao, Netherlands Antilles. We explore how educational level is related to utilization of GPs, specialists, hospitals, dentists and physiotherapists, taking into account the effects of sex, age and inequalities in health. The study also examines whether these relationships vary according to the unit of analysis: probability (or incidence) of services use versus overall volume of contacts. The data were derived from the Curaçao Health Study, a health interview survey among a random sample ( N = 2248) of the nondashinstitutionalized population aged 18 and over. The results indicate that there is socioeconomic inequity in the probability of health care utilization in Curaçao. People with a higher educational level are more likely to consult a specialist, dentist or physiotherapist, and are also more likely to be hospitalized. This is not only the case when the mediating effects of socioeconomic inequalities in health (need) are taken into account, but also before adjustment for health inequalities. In other words: there appears to be both vertical inequity (i.e. greater needs for services are not met by greater use) and horizontal inequity (i.e. similar needs for care are not met by similar levels of services use). The observed inequalities in use of specialists and hospitals contrast with findings from international research. The volume of health services use (i.e. the numbers of consultations) appears to be hardly connected with a person's position in the SES hierarchy; only dental services are used more extensively by higher educated individuals.

Equity in health care utilization: further tests based on hurdle models and Swedish micro data.

This paper tests the null hypothesis of no horizontal inequity in delivery of health care by use of count data hurdle models and Swedish micro data. It differs from most earlier work in three principal ways: First, the tests are carried out separately for physician and hospital care; second, the tests are carried out separately for the probability of seeking care and the amount of care received (given any use); and third, the tests are based on a model that includes several socioeconomic variables, e.g. income, education and size of community of residence. The paper rejects the hypothesis of no inequity because socioeconomic factors also have significant effects on utilization, e.g. income and size of community of residence. Size of community of residence has a positive significant effect on the frequency of physician visits but not on the probability of visiting a physician.