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首页> 外文期刊>Health policy and planning >Horizontal inequity in outpatient care use and untreated morbidity: evidence from nationwide surveys in India between 1995 and 2014
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Horizontal inequity in outpatient care use and untreated morbidity: evidence from nationwide surveys in India between 1995 and 2014

机译：外部护理使用的水平不公平和未经处理的发病率：1995年至2014年期间来自全国范围内的证据

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摘要

Equity in healthcare has been a long-term guiding principle of health policy in India. We estimate the change in horizontal inequities in healthcare use over two decades comparing the older population (60 years or more) with the younger population (under 60 years). We used data from the nationwide healthcare surveys conducted in India by the National Sample Survey Organization in 1995-96 and 2014 with sample sizes 633 405 and 335 499, respectively. Bivariate and multivariate logit regression analyses were used to study the socioeconomic differentials in self-reported morbidity (SRM), outpatient care and untreated morbidity. Deviations in the degree to which healthcare was distributed according to need were measured by horizontal inequity index (HI). In each consumption quintile the older population had four times higher SRM and outpatient care rate than the younger population in 2014. In 1995-96, the pro-rich inequity in outpatient care was higher for the older (HI: 0.085; 95% CI: 0.066, 0.103) than the younger population (0.039; 0.034, 0.043), but by 2014 this inequity became similar. Untreated morbidity was concentrated among the poor; more so for the older (-0.320; -0.391, -0.249) than the younger (-0.176; -0.211, -0.141) population in 2014. The use of public facilities increased most in the poorest and poor quintiles; the increase was higher for the older than the younger population in the poorest (1.19 times) and poor (1.71 times) quintiles. The use of public facilities was disproportionately higher for the poor in 2014 than in 1995-96 for the older (-0.189; -0.234, -0.145 vs -0.065; -0.129, -0.001) and the younger (-0.145; -0.175, -0.115 vs -0.056; -0.086, -0.026) population. The older population has much higher morbidity and is often more disadvantaged in obtaining treatment. Health policy in India should pay special attention to equity in access to healthcare for the older population.
机译：医疗保健的股权一直是印度卫生政策的长期指导原则。我们估计医疗保健的水平不公平的变化超过二十年，比较年龄较年轻的人口（60岁或60岁以下）。我们在1995 - 96年和2014年的国家样本调查组织中使用了1995 - 96年和2014年的全国保健调查的数据，分别具有样本规模633 405和335 499。双变量和多变量Logit回归分析用于研究自我报告的发病率（SRM），门诊护理和未经处理的发病率的社会经济差异。通过水平不平等指数（HI）测量根据需要分发医疗保健程度的偏差。在每次消费五分之一时，旧人群的SRM和门诊小心率高于2014年的小孩较高。1995 - 96年，较老的门诊护理的富裕的不公平高（HI：0.085; 95％CI： 0.066,0.103）比年轻人（0.039; 0.034,0.043），但到2014年这种不公平变得相似。未经治疗的发病率浓缩;更旧的（-0.320; -0.391，-0.249）比较年轻人（-0.176; -0.211，-0.141）人口在2014年。公共设施的使用大部分在最贫穷和贫穷的昆虫中增加了;比最贫困人口（1.19次）和贫困人口（1.71次）昆泰的年龄较大的增加的增加更高。 2014年贫困人口的使用比1995 - 96年更高的公共设施（-0.189; -0.234，-0.145 Vs -0.065; -0.129，-0.001）和年轻（-0.145; -0.175 -0.115 vs -0.056; -0.086，-0.026）人口。年龄较大的人的发病率较高，往往在获得治疗方面往往更不利地位。印度的健康政策应该特别注意获得老人民医疗保健的公平。

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