Abstract:
BACKGROUND:The Brazilian health system is founded on the principle of equity, meaning provision of equal care for equal needs. However, little is known about the impact of health policies in narrowing socioeconomic health inequalities. Using data from the Brazilian World Health Survey, this paper addresses socioeconomic inequalities in the use of outpatient services according to intensity of need. METHODS:A three-stage cluster sampling was used to select 5000 adults (18 years and over). The non-response rate was 24.7% and calibration of the natural expansion factors was necessary to obtain the demographic structure of the Brazilian population. Utilization was established by use of outpatient services in the 12 months prior to the interview. Socioeconomic inequalities were analyzed by logistic regression models using years of schooling and private health insurance as independent variables, and controlling by age and sex. Effects of the socioeconomic variables on health services utilization were further analyzed according to self-rated health (good, fair and poor), considered as an indicator of intensity of health care need. RESULTS:Among the 5000 respondents, 63.4% used an outpatient service in the year preceding the survey. The association of health services utilization and self-rated health was significant (p < 0.001). Regarding socioeconomic inequalities, the less educated used health services less frequently, despite presenting worse health conditions. Highly significant effects were found for both socioeconomic variables, years of schooling (p < 0.001) and private health insurance (p < 0.00), after controlling for age and sex. Stratifying by self-rated health, the effects of both socioeconomic variables were significant among those with good health status, but not statistically significant among those with poor self-rated health. CONCLUSIONS:The analysis showed that the social gradient in outpatient services utilization decreases as the need is more intense. Among individuals with good self-rated health, possible explanations for the inequality are the lower use of preventive services and unequal supply of health services among the socially disadvantaged groups, or excessive use of health services by the wealthy. On the other hand, our results indicate an adequate performance of the Brazilian health system in narrowing socioeconomic inequalities in health in the most serious situations of need.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Szwarcwald CL,Souza-Júnior PR,Damacena GNdoi
10.1186/1472-6963-10-217subject
Has Abstractpub_date
2010-07-23 00:00:00pages
217issn
1472-6963pii
1472-6963-10-217journal_volume
10pub_type
杂志文章abstract:BACKGROUND:The perceived responsiveness of a healthcare system reflects its ability to satisfy reasonable expectations of the public with respect to non-medical services. Recently, there has been increasing attention paid to responsiveness in evaluating the performance of a healthcare system in a variety of service set...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-1980-2
更新日期:2017-01-13 00:00:00
abstract:BACKGROUND:Several previous studies conducted on cancer registry data and hospital discharge records (HDR) have found an association between hospital volume and the recourse to breast conserving surgery (BCS) for breast cancer. The aim of the current study is to depict concurrent time trends in the recourse to BCS and ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-7-167
更新日期:2007-10-18 00:00:00
abstract:BACKGROUND:Biomedical research constantly produces new findings but these are not routinely translated into health care practice. One way to address this problem is to develop effective interventions to translate research findings into practice. Currently a range of empirical interventions are available and systematic ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-3-22
更新日期:2003-12-19 00:00:00
abstract:BACKGROUND:Clinical documentation systems, such as templates, have been associated with process utilization. The T-System emergency department (ED) templates are widely used but lacking are analyses of the templates association with processes. This system is also unique because of the many different template options av...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-65
更新日期:2011-03-24 00:00:00
abstract:BACKGROUND:Care coordination has increasingly been recognized as an important aspect of high-quality health care delivery. Robust measures of coordination processes will be essential tools to evaluate, guide and support efforts to understand and improve coordination, yet little agreement exists among stakeholders about...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/1472-6963-13-119
更新日期:2013-03-28 00:00:00
abstract:BACKGROUND:Antimicrobial resistance (AMR) is a prominent threat to public health. Although many guidelines have been developed over the years to tackle this issue, their impact on health care practice varies. Guidelines are often based on evidence from clinical trials, but these have limitations, particularly in the br...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4787-5
更新日期:2019-12-05 00:00:00
abstract:BACKGROUND:Discrete choice experiments (DCEs) are attribute-driven experimental techniques used to elicit stakeholders' preferences to support the design and implementation of policy interventions. The validity of a DCE, therefore, depends on the appropriate specification of the attributes and their levels. There have ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-235
更新日期:2014-05-22 00:00:00
abstract:BACKGROUND:A compelling ethical rationale supports patient engagement in healthcare research. It is also assumed that patient engagement will lead to research findings that are more pertinent to patients' concerns and dilemmas. However; it is unclear how to best conduct this process. In this systematic review we aimed ...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/1472-6963-14-89
更新日期:2014-02-26 00:00:00
abstract:BACKGROUND:Prevalence studies usually depend on self-report of disease status in survey data or administrative data collections and may over- or under-estimate disease prevalence. The establishment of a linked data collection provided an opportunity to explore the accuracy and completeness of capture of information abo...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-481
更新日期:2013-11-19 00:00:00
abstract:BACKGROUND:Australians born in countries where hepatitis B infection is endemic are 6-12 times more likely to develop hepatocellular cancer (HCC) than Australian-born individuals. However, a program of screening, surveillance and treatment of chronic hepatitis B (CHB) in high risk populations could significantly reduce...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-10-215
更新日期:2010-07-21 00:00:00
abstract:BACKGROUND:Patient-centered care ideally considers patient preferences, values and needs. However, it is unclear if policies such as wait time strategies for hip and knee replacement surgery (TJR) are patient-centred as they focus on an isolated episode of care. This paper describes the accounts of people scheduled to ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-531
更新日期:2013-12-23 00:00:00
abstract:BACKGROUND:Dementia is an irreversible chronic disease with wide-ranging effects on patients', caregivers' and families' lives. Hospitalizations are significant events for people with dementia. They tend to have poorer outcomes compared to those without dementia. Most of the previous studies focused on diagnoses leadin...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2484-9
更新日期:2017-08-04 00:00:00
abstract:BACKGROUND:Diabetic retinopathy (DR) is the commonest cause of preventable blindness in working age populations, but up to 98% of visual loss secondary to DR can be prevented with early detection and treatment. In 2012, an innovative outreach DR screening model was implemented in remote communities in a state of Austra...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2045-2
更新日期:2017-02-22 00:00:00
abstract:BACKGROUND:Due to a continuing age shift in the German society hospital providers are concerned about the additional costs associated with the treatment of elderly patients. It is not clear if cardiac catheterization in aged patients leads to higher resource utilization and if DRG-revenues do compensate for this factor...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-1999-4
更新日期:2017-01-18 00:00:00
abstract:BACKGROUND:Numerous drugs used in the treatment of psychiatric disorders are substrates of cytochrome P450 enzymes and are potential candidates for drug-drug interactions (DDIs). METHODS:Claims data of a German statutory health insurance company from severely mentally ill patients who registered in an integrated care ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1724-8
更新日期:2016-09-08 00:00:00
abstract:BACKGROUND:Migration has been shown to be associated with negative mental health outcomes. Moreover, migrants tend to underutilise mental health services. The current study aimed to assess the association between predictors, divided into three groups (predisposing, enabling and need), and two outcome variables: (1) pas...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-018-3504-0
更新日期:2018-09-06 00:00:00
abstract:BACKGROUND:Peripheral intravenous catheters (PIVCs) account for a mean of 38% of catheter associated bloodstream infections (CABSI) with Staphylococcus aureus, which are preventable if deficiencies in best practice are addressed. There exists no feasible and reliable quality surveillance tool assessing all important ar...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-019-4497-z
更新日期:2019-09-05 00:00:00
abstract:BACKGROUND:Despite the growing literature on the efficiency and productivity of the Chinese healthcare system, less attention has been given to examining the undesirable outputs linked to healthcare services, including environmental pollution. Taking the atmospheric environmental pollution resulting from the incinerati...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05496-9
更新日期:2020-07-22 00:00:00
abstract:BACKGROUND:Coverage is an important indicator to assess both the performance and effectiveness of public health programs. Recommended methods for coverage estimation for the treatment of severe acute malnutrition (SAM) can involve active and adaptive case finding (AACF), an informant-driven sampling procedure, for the ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4791-9
更新日期:2019-12-16 00:00:00
abstract:BACKGROUND:To evaluate the cost-effectiveness of trimetazidine (TMZ) as add-on therapy to standard-of-care (SoC) compared to SoC alone in patients with chronic stable angina who did not respond adequately to first line therapy with b-blockers, nitrates or calcium channel antagonists in Greece. METHODS:A Markov model w...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1779-6
更新日期:2016-09-27 00:00:00
abstract:BACKGROUND:Potentially inappropriate prescribing (PIP) in older people is common in primary care and can result in increased morbidity, adverse drug events, hospitalizations and mortality. The prevalence of PIP in Ireland is estimated at 36% with an associated expenditure of over €45 million in 2007. The aim of this pa...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/1472-6963-13-307
更新日期:2013-08-14 00:00:00
abstract:BACKGROUND:Several years have passed since the rural New Cooperative Medical Scheme (NCMS) in China was established and policies kept continuous improvement. Its policies on chronic diseases vary by county but have certain shared characteristics. Following this modification of medical insurance policy, this study reass...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-305
更新日期:2014-07-15 00:00:00
abstract:BACKGROUND:Struggling to correct the public-private imbalance in its health care system, the Hong Kong SAR Government seeks to introduce a government-regulated voluntary health insurance scheme, or VHIS, a distinctive financing instrument that combines the characteristics of private insurance with strong government reg...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/s12913-017-2559-7
更新日期:2017-08-25 00:00:00
abstract:BACKGROUND:Cardiovascular disease (CVD) carries a high burden of morbidity and mortality and is associated with significant utilization of health care resources, especially in the elderly. Numerous randomized trials have established the efficacy of cholesterol reduction with statin medications in decreasing mortality i...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-9-198
更新日期:2009-11-04 00:00:00
abstract:BACKGROUND:The poor physical health of people with severe mental illness (SMI) is often attributed to lifestyle, disease-related medication side effects and disparate provision of healthcare. The complexity and inexact nature of this issue prohibits the identification of a clear and concise causal pathway, which in tur...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-0744-0
更新日期:2015-03-03 00:00:00
abstract:BACKGROUND:Treat-to-target is the recommended strategy for the management of rheumatoid arthritis (RA) and involves regular assessment of disease activity using validated measures and subsequent adjustment of medical therapy if patients are not in remission or low disease activity. Recommendations published in 2012 det...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1633-x
更新日期:2016-08-15 00:00:00
abstract:BACKGROUND:In Germany, patients receiving oral anticoagulation (OAC) are often treated by general practitioners (GPs), and large proportions of patients receive vitamin K antagonists (VKAs). The quality of OAC in German GP practices, differences between various practices, and improvement potential through implementatio...
journal_title:BMC health services research
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12913-019-4372-y
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Hospital governance is broadening its orientation from cost and production controls towards 'improving performance on clinical outcomes'. Given this new focus one might assume that doctors are drawn into hospital management across OECD countries. Hospital performance in terms of patient health, quality of ca...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1396-4
更新日期:2016-05-24 00:00:00
abstract:BACKGROUND:Four social audits in 1998, 2003, 2006 and 2009 identified actions that Nicaragua could take to reduce corruption and public perception in primary health care and other key services. METHODS:In a 71-cluster sample, weighted according to the 1995 census and stratified by geographic region and settlement type...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-S2-S3
更新日期:2011-12-21 00:00:00
abstract:BACKGROUND:In the intensive care unit (ICU), checklists can be used to support the delivery of quality and consistent clinical care. While studies have reported important benefits for clinical checklists in this context, lack of formal validity testing in the literature prompted the study aim; to develop relevant 'proc...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-380
更新日期:2013-10-03 00:00:00