کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
8817890 1609007 2018 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Does free choice of hospital conflict with equity of access to highly specialized hospitals? A case study from the Danish health care system
ترجمه فارسی عنوان
آیا انتخاب آزاد بیمارستان با در اختیار داشتن دسترسی به بیمارستان های تخصصی می باشد؟ مطالعه موردی از سیستم مراقبت بهداشتی دانمارکی
کلمات کلیدی
عدالت افقی، انتخاب بیمارستان، وضعیت اجتماعی و اقتصادی، نگرش ریسک، دانمارک،
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی سیاست های بهداشت و سلامت عمومی
چکیده انگلیسی
Equity of access to health care is a central objective of European health care systems. In this study, we examined whether free choice of hospital, which has been introduced in many systems to strengthen user rights and improve hospital competition, conflicts with equity of access to highly specialized hospitals. We chose to carry out a study on 134,049 women who had uncomplicated pregnancies from 2005 to 2014 in Denmark because of their homogeneity in terms of need, the availability of behavioral data, and their expected engagement in choice of hospital. Multivariate logistic regression was used to link the dependent variable of bypassing the nearest non-highly specialized public hospital in order to “up-specialize”, with independent variables related to socioeconomic status, risk attitude, and choice premises, using administrative registries. Overall, 16,426 (12%) women were observed to bypass the nearest hospital to up-specialize. Notably, high education level was significantly associated with up-specialization, with an odds ratio of 1.50 (95% CI: 1.40-1.60, p < 0.001) compared to low education group. This confirms our hypothesis that there is a socioeconomic gradient in terms of exercising the right to a free choice of hospital, and so the results indicate that the policy exacerbates inequity of access to health care.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Health Policy - Volume 122, Issue 7, July 2018, Pages 722-727
نویسندگان
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