Is utilization of health services for HIV patients equal by socioeconomic status? Evidence from the Basque country
Identifieur interne : 001567 ( Main/Curation ); précédent : 001566; suivant : 001568Is utilization of health services for HIV patients equal by socioeconomic status? Evidence from the Basque country
Auteurs : Manuel García-Go I [Espagne] ; Roberto Nu O-Solinís [Espagne] ; Juan F. Orueta [Espagne] ; Francesco Paolucci [Australie, Italie]Source :
- International Journal for Equity in Health [ 1475-9276 ] ; 2015.
Abstract
Access to ART and health services is guaranteed under universal coverage to improve life expectancy and quality of life for HIV patients. However, it remains unknown whether patients of different socioeconomic background equally use different types of health services.
We use one-year (2010–2011) data on individual healthcare utilization and expenditures for the total population (N = 2262698) of the Basque Country. We observe the prevalence of HIV and use OLS regressions to estimate the impact on health utilization of demographic, socioeconomic characteristics, and health status in such patients.
HIV prevalence per 1000 individuals is greater the lower the socioeconomic status (0.784 for highest; 2.135 for lowest), for males (1.616) versus females (0.729), and for middle-age groups (26–45 and 46–65). Health expenditures are 11826€ greater for HIV patients than for others, but with differences by socioeconomic group derived from a different mix of services utilization (total cost of 13058€ for poorest, 14960€ for richest). Controlling for health status and demographic variables, poor HIV patients consume more on pharmaceuticals; rich in specialists and hospital care. Therefore, there is inequity in health services utilization by socioeconomic groups.
Equity in health provision for HIV patients represents a challenge even if access to treatment is guaranteed. Lack of information in poorer individuals might lead to under-provision while richer individuals might demand over-provision. We recommend establishing accurate clinical guidelines with the appropriate mix of health provision by validated need for all socioeconomic groups; promoting educational programs so that patients demand the appropriate mix of services, and stimulating integrated care for HIV patients with multiple chronic conditions.
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DOI: 10.1186/s12939-015-0215-6
PubMed: 26510922
PubMed Central: 4625850
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Evidence from the Basque country</title><author><name sortKey="Garcia Go I, Manuel" sort="Garcia Go I, Manuel" uniqKey="Garcia Go I M" first="Manuel" last="García-Go I">Manuel García-Go I</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Departamento de Economía Aplicada II, Universidad Complutense de Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Madrid, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Departamento de Economía Aplicada II, Universidad Complutense de Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region><settlement type="city">Madrid</settlement></placeName><orgName type="university">Université complutense de Madrid</orgName></affiliation></author><author><name sortKey="Nu O Solinis, Roberto" sort="Nu O Solinis, Roberto" uniqKey="Nu O Solinis R" first="Roberto" last="Nu O-Solinís">Roberto Nu O-Solinís</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Deusto Business School, University of Deusto, Bilbao, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Deusto Business School, University of Deusto, Bilbao</wicri:regionArea><wicri:noRegion>Bilbao</wicri:noRegion></affiliation></author><author><name sortKey="Orueta, Juan F" sort="Orueta, Juan F" uniqKey="Orueta J" first="Juan F." last="Orueta">Juan F. 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Evidence from the Basque country</title><author><name sortKey="Garcia Go I, Manuel" sort="Garcia Go I, Manuel" uniqKey="Garcia Go I M" first="Manuel" last="García-Go I">Manuel García-Go I</name><affiliation wicri:level="4"><nlm:aff id="Aff1">Departamento de Economía Aplicada II, Universidad Complutense de Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Madrid, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Departamento de Economía Aplicada II, Universidad Complutense de Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region><settlement type="city">Madrid</settlement></placeName><orgName type="university">Université complutense de Madrid</orgName></affiliation></author><author><name sortKey="Nu O Solinis, Roberto" sort="Nu O Solinis, Roberto" uniqKey="Nu O Solinis R" first="Roberto" last="Nu O-Solinís">Roberto Nu O-Solinís</name><affiliation wicri:level="1"><nlm:aff id="Aff2">Deusto Business School, University of Deusto, Bilbao, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Deusto Business School, University of Deusto, Bilbao</wicri:regionArea><wicri:noRegion>Bilbao</wicri:noRegion></affiliation></author><author><name sortKey="Orueta, Juan F" sort="Orueta, Juan F" uniqKey="Orueta J" first="Juan F." last="Orueta">Juan F. Orueta</name><affiliation wicri:level="1"><nlm:aff id="Aff3">Centro de Salud de Astrabudua, Osakidetza - Basque Health Service, Erandio, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Centro de Salud de Astrabudua, Osakidetza - Basque Health Service, Erandio</wicri:regionArea><wicri:noRegion>Erandio</wicri:noRegion></affiliation></author><author><name sortKey="Paolucci, Francesco" sort="Paolucci, Francesco" uniqKey="Paolucci F" first="Francesco" last="Paolucci">Francesco Paolucci</name><affiliation wicri:level="1"><nlm:aff id="Aff4">University of Murdoch, Perth, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>University of Murdoch, Perth</wicri:regionArea><wicri:noRegion>Perth</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff5">University of Bologna, Bologna, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>University of Bologna, Bologna</wicri:regionArea><wicri:noRegion>Bologna</wicri:noRegion></affiliation></author></analytic><series><title level="j">International Journal for Equity in Health</title><idno type="eISSN">1475-9276</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>Access to ART and health services is guaranteed under universal coverage to improve life expectancy and quality of life for HIV patients. However, it remains unknown whether patients of different socioeconomic background equally use different types of health services.</p></sec><sec><title>Methods</title><p>We use one-year (2010–2011) data on individual healthcare utilization and expenditures for the total population (N = 2262698) of the Basque Country. We observe the prevalence of HIV and use OLS regressions to estimate the impact on health utilization of demographic, socioeconomic characteristics, and health status in such patients.</p></sec><sec><title>Results</title><p>HIV prevalence per 1000 individuals is greater the lower the socioeconomic status (0.784 for highest; 2.135 for lowest), for males (1.616) versus females (0.729), and for middle-age groups (26–45 and 46–65). Health expenditures are 11826€ greater for HIV patients than for others, but with differences by socioeconomic group derived from a different mix of services utilization (total cost of 13058€ for poorest, 14960€ for richest). Controlling for health status and demographic variables, poor HIV patients consume more on pharmaceuticals; rich in specialists and hospital care. Therefore, there is inequity in health services utilization by socioeconomic groups.</p></sec><sec><title>Conclusions</title><p>Equity in health provision for HIV patients represents a challenge even if access to treatment is guaranteed. Lack of information in poorer individuals might lead to under-provision while richer individuals might demand over-provision. We recommend establishing accurate clinical guidelines with the appropriate mix of health provision by validated need for all socioeconomic groups; promoting educational programs so that patients demand the appropriate mix of services, and stimulating integrated care for HIV patients with multiple chronic conditions.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Piot, P" uniqKey="Piot P">P Piot</name></author><author><name sortKey="Quinn, Tc" uniqKey="Quinn T">TC Quinn</name></author><author><name sortKey="Taelman, H" uniqKey="Taelman H">H Taelman</name></author><author><name sortKey="Feinsod, Fm" uniqKey="Feinsod F">FM Feinsod</name></author><author><name sortKey="Minlangu, Kb" uniqKey="Minlangu K">KB Minlangu</name></author><author><name sortKey="Wobin, O" uniqKey="Wobin O">O Wobin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ham, C" uniqKey="Ham C">C 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Muñoz-Fernández</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wawrzyniak, Aj" uniqKey="Wawrzyniak A">AJ Wawrzyniak</name></author><author><name sortKey="Ownby, Rl" uniqKey="Ownby R">RL Ownby</name></author><author><name sortKey="Mccoy, K" uniqKey="Mccoy K">K McCoy</name></author><author><name sortKey="Waldrop Valverde, D" uniqKey="Waldrop Valverde D">D Waldrop-Valverde</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kenkel, D" uniqKey="Kenkel D">D Kenkel</name></author></analytic></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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