OBJECTIVE: To provide new evidence on whether and how patterns of health care utilization deviate from horizontal equity in a country with a universal and egalitarian public health care system: Italy. DATA SOURCES: Secondary analysis of data from the Health Conditions and Health Care Utilization Survey 2005, conducted by the Italian National Institute of Statistics on a probability sample of the noninstitutionalized Italian population. STUDY DESIGN: Using multilevel logistic regression, we investigated how the probability of utilizing five health care services varies among individuals with equal health status but different SES. DATA COLLECTION/EXTRACTION: Respondents aged 18 or older at the interview time (n = 103,651). PRINCIPAL FINDINGS: Overall, we found that use of primary care is inequitable in favor of the less well-off, hospitalization is equitable, and use of outpatient specialist care, basic medical tests, and diagnostic services is inequitable in favor of the well-off. Stratifying the analysis by health status, however, we found that the degree of inequity varies according to health status. CONCLUSIONS: Despite its universal and egalitarian public health care system, Italy exhibits a significant degree of SES-related horizontal inequity in health services utilization.
OBJECTIVE: To provide new evidence on whether and how patterns of health care utilization deviate from horizontal equity in a country with a universal and egalitarian public health care system: Italy. DATA SOURCES: Secondary analysis of data from the Health Conditions and Health Care Utilization Survey 2005, conducted by the Italian National Institute of Statistics on a probability sample of the noninstitutionalized Italian population. STUDY DESIGN: Using multilevel logistic regression, we investigated how the probability of utilizing five health care services varies among individuals with equal health status but different SES. DATA COLLECTION/EXTRACTION: Respondents aged 18 or older at the interview time (n = 103,651). PRINCIPAL FINDINGS: Overall, we found that use of primary care is inequitable in favor of the less well-off, hospitalization is equitable, and use of outpatient specialist care, basic medical tests, and diagnostic services is inequitable in favor of the well-off. Stratifying the analysis by health status, however, we found that the degree of inequity varies according to health status. CONCLUSIONS: Despite its universal and egalitarian public health care system, Italy exhibits a significant degree of SES-related horizontal inequity in health services utilization.
Authors: Iravan Masoudi Asl; Masoud Abolhallaje; Mehdi Raadabadi; Hamed Nazari; Aslan Nazari; Mohammad Salimi; Ali Javani Journal: Electron Physician Date: 2015-12-20
Authors: Pamela Barbadoro; Antonella D'Alleva; Sara Galmozzi; Gemma Zocco; Francesco Di Stanislao; Emilia Prospero; Marcello Mario D'Errico Journal: PLoS One Date: 2018-06-12 Impact factor: 3.240