什么解释了不同社会经济地位人群在医疗等待时间上的差异?

What explains differences in waiting times for health care across socioeconomic status?

Health Economics · 2020
被引 21
人大 A-

中文导读

利用丹麦行政登记数据,研究了七种计划手术中患者社会经济地位与等待时间的关系,发现不平等主要由医院间地理和制度因素解释,部分手术中非西方移民在医院内也面临不平等。

Abstract

In publicly funded health systems, waiting times act as a rationing mechanism that should be based on need rather than socioeconomic status. However, several studies suggest that individuals with higher socioeconomic status wait less. Using individual-level data from administrative registers, we estimate and explain socioeconomic inequalities in access to publicly funded care for seven planned hospital procedures in Denmark. For each procedure, we first estimate the association between patients' waiting time for health care and their socioeconomic status as measured by income and education, controlling for patient severity. Then, we investigate how much of the association remains after controlling for (i) other individual characteristics (patients' family status, labor market status, and country of origin) that may be correlated with income and education, (ii) possible selection due to patients' use of a waiting time guarantee, and (iii) hospital factors which allow us to disentangle whether inequalities in waiting times arise across hospitals or within the hospital. Only for a few procedures, we find inequalities in waiting times related to income and education. These inequalities can be explained mostly by geographical and institutional factors across hospitals. But we also find inequalities for some procedures in relation to non-Western immigrants within hospitals.

医疗等待时间社会经济地位医疗不平等丹麦医疗系统