Social class inequalities in the utilization of health care and preventive services in Spain, a country with a national health system.
Identifieur interne : 000464 ( Main/Exploration ); précédent : 000463; suivant : 000465Social class inequalities in the utilization of health care and preventive services in Spain, a country with a national health system.
Auteurs : Marco Garrido-Cumbrera [Espagne] ; Carme Borrell ; Laia Palència ; Albert Espelt ; Maica Rodríguez-Sanz ; M Isabel Pasarín ; Anton KunstSource :
- International journal of health services : planning, administration, evaluation [ 0020-7314 ] ; 2010.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Adulte (MeSH), Adulte d'âge moyen (MeSH), Classe sociale (MeSH), Disparités d'accès aux soins (MeSH), Enquêtes sur les soins de santé (MeSH), Entretiens comme sujet (MeSH), Espagne (MeSH), Femelle (MeSH), Humains (MeSH), Jeune adulte (MeSH), Mâle (MeSH), Programmes nationaux de santé (MeSH), Services de médecine préventive (statistiques et données numériques), Sujet âgé (MeSH).
- MESH :
- statistiques et données numériques : Services de médecine préventive.
- Adolescent, Adulte, Adulte d'âge moyen, Classe sociale, Disparités d'accès aux soins, Enquêtes sur les soins de santé, Entretiens comme sujet, Espagne, Femelle, Humains, Jeune adulte, Mâle, Programmes nationaux de santé, Sujet âgé.
English descriptors
- KwdEn :
- Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Female (MeSH), Health Care Surveys (MeSH), Healthcare Disparities (MeSH), Humans (MeSH), Interviews as Topic (MeSH), Male (MeSH), Middle Aged (MeSH), National Health Programs (MeSH), Preventive Health Services (statistics & numerical data), Social Class (MeSH), Spain (MeSH), Young Adult (MeSH).
- MESH :
- statistics & numerical data : Preventive Health Services.
- Adolescent, Adult, Aged, Female, Health Care Surveys, Healthcare Disparities, Humans, Interviews as Topic, Male, Middle Aged, National Health Programs, Social Class, Spain, Young Adult.
Abstract
In Spain, despite the existence of a National Health System (NHS), the utilization of some curative health services is related to social class. This study assesses (1) whether these inequalities are also observed for preventive health services and (2) the role of additional private health insurance for people of advantaged social classes. Using data from the Spanish National Health Survey of 2006, the authors analyze the relationships between social class and use of health services by means of Poisson regression models with robust variance, controlling for self-assessed health. Similar analyses were performed for waiting times for visits to a general practitioner (GP) and specialist. After controlling for self-perceived health, men and women from social classes IV-V had a higher probability of visiting the GP than other social classes, but a lower probability of visiting a specialist or dentist. No large class differences were observed in frequency of hospitalization or emergency services use, or in breast cancer screening or influenza vaccination; cervical cancer screening frequency was lower among women from social classes IV-V. The inequalities in specialist visits, dentist visits, and cervical cancer screening were larger among people with only NHS insurance than those with double health insurance. Social class differences in waiting times were observed for specialist visits, but not for GP visits. Men and women from social classes IV-V had longer waits for a specialist; this was most marked among people with only NHS insurance. Clearly, within the NHS, social class inequalities are still evident for some curative and preventive services. Further research is needed to identify the factors driving these inequalities and to tackle these factors from within the NHS. Priority areas include specialist services, dental care, and cervical cancer screening.
DOI: 10.2190/HS.40.3.h
PubMed: 20799674
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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sort="Espelt, Albert" uniqKey="Espelt A" first="Albert" last="Espelt">Albert Espelt</name></author><author><name sortKey="Rodriguez Sanz, Maica" sort="Rodriguez Sanz, Maica" uniqKey="Rodriguez Sanz M" first="Maica" last="Rodríguez-Sanz">Maica Rodríguez-Sanz</name></author><author><name sortKey="Pasarin, M Isabel" sort="Pasarin, M Isabel" uniqKey="Pasarin M" first="M Isabel" last="Pasarín">M Isabel Pasarín</name></author><author><name sortKey="Kunst, Anton" sort="Kunst, Anton" uniqKey="Kunst A" first="Anton" last="Kunst">Anton Kunst</name></author></analytic><series><title level="j">International journal of health services : planning, administration, evaluation</title><idno type="ISSN">0020-7314</idno><imprint><date when="2010" type="published">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Female (MeSH)</term><term>Health Care Surveys (MeSH)</term><term>Healthcare Disparities (MeSH)</term><term>Humans (MeSH)</term><term>Interviews as Topic (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>National Health Programs (MeSH)</term><term>Preventive Health Services (statistics & numerical data)</term><term>Social Class (MeSH)</term><term>Spain (MeSH)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Classe sociale (MeSH)</term><term>Disparités d'accès aux soins (MeSH)</term><term>Enquêtes sur les soins de santé (MeSH)</term><term>Entretiens comme sujet (MeSH)</term><term>Espagne (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Jeune adulte (MeSH)</term><term>Mâle (MeSH)</term><term>Programmes nationaux de santé (MeSH)</term><term>Services de médecine préventive (statistiques et données numériques)</term><term>Sujet âgé (MeSH)</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Preventive Health Services</term></keywords><keywords scheme="MESH" qualifier="statistiques et données numériques" xml:lang="fr"><term>Services de médecine préventive</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Female</term><term>Health Care Surveys</term><term>Healthcare Disparities</term><term>Humans</term><term>Interviews as Topic</term><term>Male</term><term>Middle Aged</term><term>National Health Programs</term><term>Social Class</term><term>Spain</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Classe sociale</term><term>Disparités d'accès aux soins</term><term>Enquêtes sur les soins de santé</term><term>Entretiens comme 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This study assesses (1) whether these inequalities are also observed for preventive health services and (2) the role of additional private health insurance for people of advantaged social classes. Using data from the Spanish National Health Survey of 2006, the authors analyze the relationships between social class and use of health services by means of Poisson regression models with robust variance, controlling for self-assessed health. Similar analyses were performed for waiting times for visits to a general practitioner (GP) and specialist. After controlling for self-perceived health, men and women from social classes IV-V had a higher probability of visiting the GP than other social classes, but a lower probability of visiting a specialist or dentist. No large class differences were observed in frequency of hospitalization or emergency services use, or in breast cancer screening or influenza vaccination; cervical cancer screening frequency was lower among women from social classes IV-V. The inequalities in specialist visits, dentist visits, and cervical cancer screening were larger among people with only NHS insurance than those with double health insurance. Social class differences in waiting times were observed for specialist visits, but not for GP visits. Men and women from social classes IV-V had longer waits for a specialist; this was most marked among people with only NHS insurance. Clearly, within the NHS, social class inequalities are still evident for some curative and preventive services. Further research is needed to identify the factors driving these inequalities and to tackle these factors from within the NHS. Priority areas include specialist services, dental care, and cervical cancer screening.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">20799674</PMID><DateCompleted><Year>2010</Year><Month>10</Month><Day>05</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>01</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0020-7314</ISSN><JournalIssue CitedMedium="Print"><Volume>40</Volume><Issue>3</Issue><PubDate><Year>2010</Year></PubDate></JournalIssue><Title>International journal of health services : planning, administration, evaluation</Title><ISOAbbreviation>Int J Health Serv</ISOAbbreviation></Journal><ArticleTitle>Social class inequalities in the utilization of health care and preventive services in Spain, a country with a national health system.</ArticleTitle><Pagination><MedlinePgn>525-42</MedlinePgn></Pagination><Abstract><AbstractText>In Spain, despite the existence of a National Health System (NHS), the utilization of some curative health services is related to social class. This study assesses (1) whether these inequalities are also observed for preventive health services and (2) the role of additional private health insurance for people of advantaged social classes. Using data from the Spanish National Health Survey of 2006, the authors analyze the relationships between social class and use of health services by means of Poisson regression models with robust variance, controlling for self-assessed health. Similar analyses were performed for waiting times for visits to a general practitioner (GP) and specialist. After controlling for self-perceived health, men and women from social classes IV-V had a higher probability of visiting the GP than other social classes, but a lower probability of visiting a specialist or dentist. No large class differences were observed in frequency of hospitalization or emergency services use, or in breast cancer screening or influenza vaccination; cervical cancer screening frequency was lower among women from social classes IV-V. The inequalities in specialist visits, dentist visits, and cervical cancer screening were larger among people with only NHS insurance than those with double health insurance. Social class differences in waiting times were observed for specialist visits, but not for GP visits. Men and women from social classes IV-V had longer waits for a specialist; this was most marked among people with only NHS insurance. Clearly, within the NHS, social class inequalities are still evident for some curative and preventive services. Further research is needed to identify the factors driving these inequalities and to tackle these factors from within the NHS. 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