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Health care on equal terms?: assessing horizontal equity in health care use in northern Sweden
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. Department of Nursing I, University of Basque Country, Bilbao, Spain.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa. (Arcum)
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
2017 (Engelska)Ingår i: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, nr 4, s. 637-643Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: The Swedish health care system has successively moved toward increased market-orientation, which has raised concerns as to whether Sweden still offers health on equal terms. To explore this issue, this study aimed (i) to assess if the principles of horizontal equity (equal access for equal need regardless of socio-economic factors) are met in Northern Sweden 2006-14; and (ii) to explore the contribution of different factors to the inequalities in access along the same period. Data came from cross sectional surveys known in 2006, 2010 and 2014 targeting 16-84-year-old residents in the four northern-most counties in Sweden. The horizontal inequity index was calculated based on variables representing (i) the individual socioeconomic status, (ii) the health care needs, (iii) non-need factors as well as (iv) health care utilization: general practitioner (GP), specialist doctors, hospitalization. Decomposition analysis of the concentration index for need-standardized health care utilization was applied. Adjusting for needs, there was a higher use of GP services by rich people during the two last surveys, a roughly equal use of specialists, and hospitalization concentrated among the poor but with a clear time trend toward equality. The pro-rich inequalities in GP use were to a large part explained by the income gap. While health care utilization can be considered equitable regarding specialist and hospital use, the increasing pro-rich trend in the use of GP is a concern. Further studies are required to investigate the reasons and a constant monitoring of socioeconomic differences in health care access is recommended.

Ort, förlag, år, upplaga, sidor
2017. Vol. 27, nr 4, s. 637-643
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-133000DOI: 10.1093/eurpub/ckx031ISI: 000407142100013PubMedID: 28340208OAI: oai:DiVA.org:umu-133000DiVA, id: diva2:1085129
Tillgänglig från: 2017-03-28 Skapad: 2017-03-28 Senast uppdaterad: 2018-06-09Bibliografiskt granskad

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San Sebastián, MiguelMosquera, Paola ANg, NawiGustafsson, Per E

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European Journal of Public Health
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi

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