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首页> 外文期刊>Health policy and planning >Taking account of context: how important are household characteristics in explaining adult health-seeking behaviour? The case of Vietnam.
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Taking account of context: how important are household characteristics in explaining adult health-seeking behaviour? The case of Vietnam.

机译：考虑到背景：家庭特征在解释成人寻求健康行为方面有多重要？越南的情况。

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摘要

Understanding the factors affecting the utilization of health services is essential for health planners, especially in low income countries where increasing access to and use of health services is one of the main policy goals of government. While much has been written on adult health-seeking behaviour, there is comparatively little known about the influence of the broader context such as the effects of family and community on individual use of health care services in low income countries. Using Vietnam's latest National Household Survey data, this paper empirically assesses the influence of individual- and household-level factors on the use of health care services, while controlling for the unobserved household-level effects. The estimates obtained from a multilevel logistic regression model suggest that the individual's likelihood of seeking treatment is jointly determined by the observed individual- and household-level characteristics as well as unobserved household-level effects. The chance of seeking medical treatment when ill varies strongly with the observed individual- and household-level covariates, including health insurance status, income, the type and severity of illness, the number of other household members with an ailment and the presence of young children in the household. However, the variability implied by the unobservable household-level effects outweighs the variability implied by the observed covariates, indicating a high degree of homogeneity in health-seeking behaviour among the household members. Failure to take account of homogeneity in health-seeking behaviour among the household members leads not only to biased results but also to inefficient policy targeting. Policies aimed at increasing access to and the use of medical services need to be sympathetic to both individuals and households.
机译：对于卫生计划人员来说，了解影响卫生服务利用的因素至关重要，尤其是在低收入国家，在这些国家，增加获得卫生服务的机会和使用是政府的主要政策目标之一。尽管关于成年人寻求健康的行为已有很多文献报道，但对于诸如家庭和社区对低收入国家个人使用卫生保健服务的影响等更广泛背景的影响知之甚少。本文使用越南最新的全国家庭调查数据，从经验上评估了个人和家庭因素对医疗服务使用的影响，同时控制了未观察到的家庭影响。从多级逻辑回归模型获得的估计值表明，个体寻求治疗的可能性由观察到的个体和家庭水平特征以及未观察到的家庭水平效应共同决定。生病时寻求医疗救助的机会随观察到的个人和家庭水平的协变量而有很大差异，包括健康保险的状况，收入，疾病的类型和严重性，患病的其他家庭成员的数量以及年幼的孩子在家庭中。然而，不可观察的家庭水平效应所隐含的变异性大于所观察到的协变量所隐含的变异性，这表明家庭成员在寻求健康行为方面具有高度的同质性。没有考虑到家庭成员在寻求健康行为方面的同质性，不仅导致结果有偏见，而且导致政策目标低效。旨在增加获得和使用医疗服务的政策必须同情个人和家庭。

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