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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Disparities in self-rated health, health care utilization, illness, chronic illness and other socioeconomic characteristics of the Insured and Uninsured
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Disparities in self-rated health, health care utilization, illness, chronic illness and other socioeconomic characteristics of the Insured and Uninsured

机译：被保险人和未保险人的自评健康，医疗保健利用，疾病，慢性病和其他社会经济特征方面的差异

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Background: Previous studies which have examined health status as regards the insured and the uninsured have used a piecemeal approach. Aims: This study elucidates information on the self-rated health status, health care utilization, income distribution and health insurance status of Jamaicans. It also models self-rated health status, health care utilization and income distribution and how these differ between the insured and the uninsured. Methods And Material: Cross-sectional data from the 2007 Jamaica Survey of Living Conditions (JSLC) were used to analyze the information for this study. Statistical Analyses Used: The statistics were analyzed by using the Statistical Package for the Social Sciences for Windows, Version 16.0. Analytic models using multiple logistic and linear regressions were used to determine factors which explained self-rated health status, health care utilization and income distribution. Result: The majority of health insurance was owned by those in the upper class, (65%), as compared to 19% for those in the lower socio-economic strata. No significant statistical difference was found between the average medical expenditure of those who had insurance coverage and the non-insured. Insured respondents were 1.5 times (Odds ratio, OR, 95% CI = 1.06 ? 2.15) more likely to rate their health as moderate-to-very good as compared to the uninsured, and they were 1.9 times (95% CI = 1.31-2.64) more likely to seek medical care, 1.6 times (95% CI = 1.02-2.42) more likely to report having chronic illness and more likely to have greater income than the uninsured. Illness is a strong predictor of why Jamaicans seek medical care (R2 = 71.2%) and health insurance coverage accounted for less than half a percent of the variance in health care utilization. Health care utilization is a strong predictor of self-reported illness, but it was weaker than illness in explaining health care utilization (61.1% of 66.5%). Public health insurance was mostly acquired by those with chronic illnesses: (76%) as compared to 44% private health coverage and 38% without coverage. Conclusion: The findings highlighted that any reduction in the health care budget in developing nations means that vulnerable groups will seek less care and this will further increase the mortality among those cohorts.
机译：背景：以前的研究针对被保险人和未保险人的健康状况进行了零星的研究。目的：本研究阐明有关牙买加人的自评健康状况，医疗保健利用，收入分配和健康保险状况的信息。它还对自我评估的健康状况，医疗保健利用和收入分配以及被保险人和未保险人之间的差异进行了建模。方法和材料：使用2007年牙买加生活状况调查（JSLC）的横断面数据分析该研究的信息。使用的统计分析：使用Windows社会科学统计软件包16.0版对统计数据进行分析。使用多元逻辑和线性回归的分析模型来确定解释自我评估的健康状况，医疗保健利用率和收入分配的因素。结果：大多数健康保险归上层阶级所有（65％），而下层社会经济阶层中只有19％。在有保险的人和没有保险的人的平均医疗支出之间没有发现显着的统计学差异。与未投保人相比，被保险人的健康评价为中到很好的可能性高1.5倍（赔率或OR，95％CI = 1.06？2.15），而对他们的健康评价是1.9倍（95％CI = 1.31）。 2.64）更有可能就医，是慢性病的1.6倍（95％CI = 1.02-2.42），比未投保的人收入更高。疾病是牙买加人为何寻求医疗服务的有力预测指标（R2 = 71.2％），而医疗保险的覆盖率不到医疗服务利用率差异的0.5％。卫生保健利用率是自我报告疾病的有力预测指标，但在解释卫生保健利用率方面比疾病弱（66.5％的61.1％）。公共健康保险主要由患有慢性疾病的人获得：（76％），相比之下，私人健康保险占44％，无医疗保险占38％。结论：调查结果强调，发展中国家医疗保健预算的任何减少都意味着弱势群体将寻求更少的医疗服务，这将进一步增加这些人群的死亡率。

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