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首页> 外文期刊>Social science and medicine >Inequity and inequality in the use of health care in England: an empirical investigation.
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Inequity and inequality in the use of health care in England: an empirical investigation.

机译：英国医疗保健使用中的不平等和不平等：一项实证研究。

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摘要

Achieving equity in healthcare, in the form of equal use for equal need, is an objective of many healthcare systems. The evaluation of equity requires value judgements as well as analysis of data. Previous studies are limited in the range of health and supply variables considered but show a pro-poor distribution of general practitioner consultations and inpatient services and a pro-rich distribution of outpatient visits. We investigate inequality and inequity in the use of general practitioner consultations, outpatient visits, day cases and inpatient stays in England with a unique linked data set that combines rich information on the health of individuals and their socio-economic circumstances with information on local supply factors. The data are for the period 1998-2000, just prior to the introduction of a set of National Health Service (NHS) reforms with potential equity implications. We find inequalities in utilisation with respect to income, ethnicity, employment status and education. Low-income individuals and ethnic minorities have lower use of secondary care despite having higher use of primary care. Ward level supply factors affect utilisation and are important for investigating health care inequality. Our results show some evidence of inequity prior to the reforms and provide a baseline against which the effects of the new NHS can be assessed.
机译：以平等使用，平等需求的形式实现医疗保健公平是许多医疗保健系统的目标。股权评估需要价值判断以及数据分析。先前的研究在所考虑的健康和供应变量的范围内受到限制，但显示全科医生会诊和住院服务的贫富分布以及门诊就诊的富裕分布。我们通过独特的链接数据集来调查全科医生咨询，门诊就诊，日间病例和住院天数在英国的使用中的不平等和不平等现象，该数据集将有关个人健康及其社会经济状况的丰富信息与本地供应因素的信息相结合。数据是1998-2000年期间的数据，就在即将进行一系列可能对公平性产生影响的国家卫生服务（NHS）改革之前。我们发现在收入，种族，就业状况和教育方面，利用率存在不平等现象。低收入个人和少数族裔虽然对初级保健的使用较多，但对二级保健的使用较少。病房水平的供应因素影响利用率，对于调查医疗保健不平等状况很重要。我们的结果显示了一些在改革之前存在不平等现象的证据，并提供了可以评估新NHS效果的基准。

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