Equity in prevention and health care.
Identifieur interne : 000097 ( Main/Exploration ); précédent : 000096; suivant : 000098Equity in prevention and health care.
Auteurs : V. Lorant [Belgique] ; B. Boland ; P. Humblet ; D. DeliègeSource :
- Journal of epidemiology and community health [ 0143-005X ] ; 2002.
Descripteurs français
- KwdFr :
- Acceptation des soins par le patient (), Accessibilité des services de santé (organisation et administration), Adulte, Adulte d'âge moyen, Analyse multivariée, Belgique, Dépistage systématique (), Facteurs socioéconomiques, Femelle, Frottis vaginal (), Grippe humaine (), Humains, Hypercholestérolémie (), Immunisation (), Mammographie (), Mâle, Odds ratio, Services de médecine préventive (), Sujet âgé, Test de Papanicolaou, Tumeurs du col de l'utérus (), Tumeurs du sein (), Études transversales.
- MESH :
- organisation et administration : Accessibilité des services de santé.
- Acceptation des soins par le patient, Adulte, Adulte d'âge moyen, Analyse multivariée, Belgique, Dépistage systématique, Facteurs socioéconomiques, Femelle, Frottis vaginal, Grippe humaine, Humains, Hypercholestérolémie, Immunisation, Mammographie, Mâle, Odds ratio, Services de médecine préventive, Sujet âgé, Test de Papanicolaou, Tumeurs du col de l'utérus, Tumeurs du sein, Études transversales.
English descriptors
- KwdEn :
- Adult, Aged, Belgium, Breast Neoplasms (prevention & control), Cross-Sectional Studies, Female, Health Services Accessibility (organization & administration), Humans, Hypercholesterolemia (prevention & control), Immunization (statistics & numerical data), Influenza, Human (prevention & control), Male, Mammography (statistics & numerical data), Mass Screening (statistics & numerical data), Middle Aged, Multivariate Analysis, Odds Ratio, Papanicolaou Test, Patient Acceptance of Health Care (statistics & numerical data), Preventive Health Services (statistics & numerical data), Socioeconomic Factors, Uterine Cervical Neoplasms (prevention & control), Vaginal Smears (statistics & numerical data).
- MESH :
- organization & administration : Health Services Accessibility.
- prevention & control : Breast Neoplasms, Hypercholesterolemia, Influenza, Human, Uterine Cervical Neoplasms.
- statistics & numerical data : Immunization, Mammography, Mass Screening, Patient Acceptance of Health Care, Preventive Health Services, Vaginal Smears.
- Adult, Aged, Belgium, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Multivariate Analysis, Odds Ratio, Papanicolaou Test, Socioeconomic Factors.
Abstract
STUDY OBJECTIVE
There is an increasing body of evidence about socioeconomic inequality in preventive use, mostly for cancer screening. But as far as needs of prevention are unequally distributed, even equal use may not be fair. Moreover, prevention might be unequally used in the same way as health care in general. The objective of the paper is to assess inequity in prevention and to compare socioeconomic inequity in preventive medicine with that in health care.
DESIGN
A cross sectional Health Interview Survey was carried out in 1997 by face to face interview and self administered questionnaire. Two types of health care utilisation were considered (contacts with GPs and with specialists) and four preventive care mostly delivered in a GP setting (flu vaccination, cholesterol screening) or in a specialty setting (mammography and pap smear).
SETTING
Belgium.
PARTICIPANTS
A representative sample of 7378 residents aged 25 years and over (participation rate: 61%).
OUTCOME MEASURE
Socioeconomic inequity was measured by the HI(wvp) index, which is the difference between use inequality and needs inequality. Needs was computed as the expected use by the risk factors or target groups.
MAIN RESULTS
There was significant inequity for all medical contacts and preventive medicine. Medical contacts showed inequity favouring the rich for specialist visits and inequity favouring the poor for contacts with GPs. Regarding preventive medicine, inequity was high and favoured the rich for mammography and cervical screening; inequity was lower for flu immunisation and cholesterol screening but still favoured the higher socioeconomic groups. In the general practice setting, inequity in prevention was higher than inequity in health care; in the specialty setting, inequity in prevention was not statistically different from inequity in health care, although it was higher than in the general practice setting.
CONCLUSIONS
If inequity in preventive medicine is to be lowered, the role of the GP must be fostered and access to specialty medicine increased, especially for cancer screening.
DOI: 10.1136/jech.56.7.510
PubMed: 12080158
Affiliations:
Links toward previous steps (curation, corpus...)
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Lorant</name><affiliation wicri:level="4"><nlm:affiliation>Health Sociology and Economics, School of Public Health, Faculty of Medicine, Université Catholique de Louvain, Brussels, Belgium. lorant@sesa.ucl.ac.be</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Health Sociology and Economics, School of Public Health, Faculty of Medicine, Université Catholique de Louvain, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName><orgName type="university">Université catholique de Louvain</orgName></affiliation></author><author><name sortKey="Boland, B" sort="Boland, B" uniqKey="Boland B" first="B" last="Boland">B. Boland</name></author><author><name sortKey="Humblet, P" sort="Humblet, P" uniqKey="Humblet P" first="P" last="Humblet">P. Humblet</name></author><author><name sortKey="Deliege, D" sort="Deliege, D" uniqKey="Deliege D" first="D" last="Deliège">D. Deliège</name></author></analytic><series><title level="j">Journal of epidemiology and community health</title><idno type="ISSN">0143-005X</idno><imprint><date when="2002" type="published">2002</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Belgium</term><term>Breast Neoplasms (prevention & control)</term><term>Cross-Sectional Studies</term><term>Female</term><term>Health Services Accessibility (organization & administration)</term><term>Humans</term><term>Hypercholesterolemia (prevention & control)</term><term>Immunization (statistics & numerical data)</term><term>Influenza, Human (prevention & control)</term><term>Male</term><term>Mammography (statistics & numerical data)</term><term>Mass Screening (statistics & numerical data)</term><term>Middle Aged</term><term>Multivariate Analysis</term><term>Odds Ratio</term><term>Papanicolaou Test</term><term>Patient Acceptance of Health Care (statistics & numerical data)</term><term>Preventive Health Services (statistics & numerical data)</term><term>Socioeconomic Factors</term><term>Uterine Cervical Neoplasms (prevention & control)</term><term>Vaginal Smears (statistics & numerical data)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Acceptation des soins par le patient ()</term><term>Accessibilité des services de santé (organisation et administration)</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse multivariée</term><term>Belgique</term><term>Dépistage systématique ()</term><term>Facteurs socioéconomiques</term><term>Femelle</term><term>Frottis vaginal ()</term><term>Grippe humaine ()</term><term>Humains</term><term>Hypercholestérolémie ()</term><term>Immunisation ()</term><term>Mammographie ()</term><term>Mâle</term><term>Odds ratio</term><term>Services de médecine préventive ()</term><term>Sujet âgé</term><term>Test de Papanicolaou</term><term>Tumeurs du col de l'utérus ()</term><term>Tumeurs du sein ()</term><term>Études transversales</term></keywords><keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Accessibilité des services de santé</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Health Services Accessibility</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Breast Neoplasms</term><term>Hypercholesterolemia</term><term>Influenza, Human</term><term>Uterine Cervical Neoplasms</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Immunization</term><term>Mammography</term><term>Mass Screening</term><term>Patient Acceptance of Health Care</term><term>Preventive Health Services</term><term>Vaginal Smears</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Belgium</term><term>Cross-Sectional Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Multivariate Analysis</term><term>Odds Ratio</term><term>Papanicolaou Test</term><term>Socioeconomic Factors</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Acceptation des soins par le patient</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse multivariée</term><term>Belgique</term><term>Dépistage systématique</term><term>Facteurs socioéconomiques</term><term>Femelle</term><term>Frottis vaginal</term><term>Grippe humaine</term><term>Humains</term><term>Hypercholestérolémie</term><term>Immunisation</term><term>Mammographie</term><term>Mâle</term><term>Odds ratio</term><term>Services de médecine préventive</term><term>Sujet âgé</term><term>Test de Papanicolaou</term><term>Tumeurs du col de l'utérus</term><term>Tumeurs du sein</term><term>Études transversales</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>STUDY OBJECTIVE</b></p><p>There is an increasing body of evidence about socioeconomic inequality in preventive use, mostly for cancer screening. But as far as needs of prevention are unequally distributed, even equal use may not be fair. Moreover, prevention might be unequally used in the same way as health care in general. The objective of the paper is to assess inequity in prevention and to compare socioeconomic inequity in preventive medicine with that in health care.</p></div><div type="abstract" xml:lang="en"><p><b>DESIGN</b></p><p>A cross sectional Health Interview Survey was carried out in 1997 by face to face interview and self administered questionnaire. Two types of health care utilisation were considered (contacts with GPs and with specialists) and four preventive care mostly delivered in a GP setting (flu vaccination, cholesterol screening) or in a specialty setting (mammography and pap smear).</p></div><div type="abstract" xml:lang="en"><p><b>SETTING</b></p><p>Belgium.</p></div><div type="abstract" xml:lang="en"><p><b>PARTICIPANTS</b></p><p>A representative sample of 7378 residents aged 25 years and over (participation rate: 61%).</p></div><div type="abstract" xml:lang="en"><p><b>OUTCOME MEASURE</b></p><p>Socioeconomic inequity was measured by the HI(wvp) index, which is the difference between use inequality and needs inequality. Needs was computed as the expected use by the risk factors or target groups.</p></div><div type="abstract" xml:lang="en"><p><b>MAIN RESULTS</b></p><p>There was significant inequity for all medical contacts and preventive medicine. Medical contacts showed inequity favouring the rich for specialist visits and inequity favouring the poor for contacts with GPs. Regarding preventive medicine, inequity was high and favoured the rich for mammography and cervical screening; inequity was lower for flu immunisation and cholesterol screening but still favoured the higher socioeconomic groups. In the general practice setting, inequity in prevention was higher than inequity in health care; in the specialty setting, inequity in prevention was not statistically different from inequity in health care, although it was higher than in the general practice setting.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>If inequity in preventive medicine is to be lowered, the role of the GP must be fostered and access to specialty medicine increased, especially for cancer screening.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">12080158</PMID><DateCompleted><Year>2002</Year><Month>07</Month><Day>31</Day></DateCompleted><DateRevised><Year>2019</Year><Month>05</Month><Day>03</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0143-005X</ISSN><JournalIssue CitedMedium="Print"><Volume>56</Volume><Issue>7</Issue><PubDate><Year>2002</Year><Month>Jul</Month></PubDate></JournalIssue><Title>Journal of epidemiology and community health</Title><ISOAbbreviation>J Epidemiol Community Health</ISOAbbreviation></Journal><ArticleTitle>Equity in prevention and health care.</ArticleTitle><Pagination><MedlinePgn>510-6</MedlinePgn></Pagination><Abstract><AbstractText Label="STUDY OBJECTIVE" NlmCategory="OBJECTIVE">There is an increasing body of evidence about socioeconomic inequality in preventive use, mostly for cancer screening. But as far as needs of prevention are unequally distributed, even equal use may not be fair. Moreover, prevention might be unequally used in the same way as health care in general. The objective of the paper is to assess inequity in prevention and to compare socioeconomic inequity in preventive medicine with that in health care.</AbstractText><AbstractText Label="DESIGN" NlmCategory="METHODS">A cross sectional Health Interview Survey was carried out in 1997 by face to face interview and self administered questionnaire. Two types of health care utilisation were considered (contacts with GPs and with specialists) and four preventive care mostly delivered in a GP setting (flu vaccination, cholesterol screening) or in a specialty setting (mammography and pap smear).</AbstractText><AbstractText Label="SETTING" NlmCategory="METHODS">Belgium.</AbstractText><AbstractText Label="PARTICIPANTS" NlmCategory="METHODS">A representative sample of 7378 residents aged 25 years and over (participation rate: 61%).</AbstractText><AbstractText Label="OUTCOME MEASURE" NlmCategory="METHODS">Socioeconomic inequity was measured by the HI(wvp) index, which is the difference between use inequality and needs inequality. Needs was computed as the expected use by the risk factors or target groups.</AbstractText><AbstractText Label="MAIN RESULTS" NlmCategory="RESULTS">There was significant inequity for all medical contacts and preventive medicine. Medical contacts showed inequity favouring the rich for specialist visits and inequity favouring the poor for contacts with GPs. Regarding preventive medicine, inequity was high and favoured the rich for mammography and cervical screening; inequity was lower for flu immunisation and cholesterol screening but still favoured the higher socioeconomic groups. In the general practice setting, inequity in prevention was higher than inequity in health care; in the specialty setting, inequity in prevention was not statistically different from inequity in health care, although it was higher than in the general practice setting.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">If inequity in preventive medicine is to be lowered, the role of the GP must be fostered and access to specialty medicine increased, especially for cancer screening.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lorant</LastName><ForeName>V</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Health Sociology and Economics, School of Public Health, Faculty of Medicine, Université Catholique de Louvain, Brussels, Belgium. lorant@sesa.ucl.ac.be</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boland</LastName><ForeName>B</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Humblet</LastName><ForeName>P</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Deliège</LastName><ForeName>D</ForeName><Initials>D</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Epidemiol Community Health</MedlineTA><NlmUniqueID>7909766</NlmUniqueID><ISSNLinking>0143-005X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001530" MajorTopicYN="N">Belgium</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001943" MajorTopicYN="N">Breast Neoplasms</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003430" MajorTopicYN="N">Cross-Sectional Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006297" MajorTopicYN="N">Health Services Accessibility</DescriptorName><QualifierName UI="Q000458" MajorTopicYN="N">organization & administration</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006937" MajorTopicYN="N">Hypercholesterolemia</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007114" MajorTopicYN="N">Immunization</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D007251" MajorTopicYN="N">Influenza, Human</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008327" MajorTopicYN="N">Mammography</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008403" MajorTopicYN="N">Mass Screening</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015999" MajorTopicYN="N">Multivariate Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016017" MajorTopicYN="N">Odds Ratio</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D065006" MajorTopicYN="N">Papanicolaou Test</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010342" MajorTopicYN="N">Patient Acceptance of Health Care</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011314" MajorTopicYN="N">Preventive Health Services</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012959" MajorTopicYN="N">Socioeconomic Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002583" MajorTopicYN="N">Uterine Cervical Neoplasms</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014626" MajorTopicYN="N">Vaginal Smears</DescriptorName><QualifierName UI="Q000706" 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Boland</name><name sortKey="Deliege, D" sort="Deliege, D" uniqKey="Deliege D" first="D" last="Deliège">D. Deliège</name><name sortKey="Humblet, P" sort="Humblet, P" uniqKey="Humblet P" first="P" last="Humblet">P. Humblet</name></noCountry><country name="Belgique"><region name="Région de Bruxelles-Capitale"><name sortKey="Lorant, V" sort="Lorant, V" uniqKey="Lorant V" first="V" last="Lorant">V. Lorant</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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