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Is utilization of health services for HIV patients equal by socioeconomic status? Evidence from the Basque country

INTRODUCTION: Access to ART and health services is guaranteed under universal coverage to improve life expectancy and quality of life for HIV patients. However, it remains unknown whether patients of different socioeconomic background equally use different types of health services. METHODS: We use o...

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Autores principales: García-Goñi, Manuel, Nuño-Solinís, Roberto, Orueta, Juan F., Paolucci, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625850/
https://www.ncbi.nlm.nih.gov/pubmed/26510922
http://dx.doi.org/10.1186/s12939-015-0215-6
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author García-Goñi, Manuel
Nuño-Solinís, Roberto
Orueta, Juan F.
Paolucci, Francesco
author_facet García-Goñi, Manuel
Nuño-Solinís, Roberto
Orueta, Juan F.
Paolucci, Francesco
author_sort García-Goñi, Manuel
collection PubMed
description INTRODUCTION: Access to ART and health services is guaranteed under universal coverage to improve life expectancy and quality of life for HIV patients. However, it remains unknown whether patients of different socioeconomic background equally use different types of health services. METHODS: We use one-year (2010–2011) data on individual healthcare utilization and expenditures for the total population (N = 2262698) of the Basque Country. We observe the prevalence of HIV and use OLS regressions to estimate the impact on health utilization of demographic, socioeconomic characteristics, and health status in such patients. RESULTS: HIV prevalence per 1000 individuals is greater the lower the socioeconomic status (0.784 for highest; 2.135 for lowest), for males (1.616) versus females (0.729), and for middle-age groups (26–45 and 46–65). Health expenditures are 11826€ greater for HIV patients than for others, but with differences by socioeconomic group derived from a different mix of services utilization (total cost of 13058€ for poorest, 14960€ for richest). Controlling for health status and demographic variables, poor HIV patients consume more on pharmaceuticals; rich in specialists and hospital care. Therefore, there is inequity in health services utilization by socioeconomic groups. CONCLUSIONS: Equity in health provision for HIV patients represents a challenge even if access to treatment is guaranteed. Lack of information in poorer individuals might lead to under-provision while richer individuals might demand over-provision. We recommend establishing accurate clinical guidelines with the appropriate mix of health provision by validated need for all socioeconomic groups; promoting educational programs so that patients demand the appropriate mix of services, and stimulating integrated care for HIV patients with multiple chronic conditions.
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spelling pubmed-46258502015-10-30 Is utilization of health services for HIV patients equal by socioeconomic status? Evidence from the Basque country García-Goñi, Manuel Nuño-Solinís, Roberto Orueta, Juan F. Paolucci, Francesco Int J Equity Health Research INTRODUCTION: Access to ART and health services is guaranteed under universal coverage to improve life expectancy and quality of life for HIV patients. However, it remains unknown whether patients of different socioeconomic background equally use different types of health services. METHODS: We use one-year (2010–2011) data on individual healthcare utilization and expenditures for the total population (N = 2262698) of the Basque Country. We observe the prevalence of HIV and use OLS regressions to estimate the impact on health utilization of demographic, socioeconomic characteristics, and health status in such patients. RESULTS: HIV prevalence per 1000 individuals is greater the lower the socioeconomic status (0.784 for highest; 2.135 for lowest), for males (1.616) versus females (0.729), and for middle-age groups (26–45 and 46–65). Health expenditures are 11826€ greater for HIV patients than for others, but with differences by socioeconomic group derived from a different mix of services utilization (total cost of 13058€ for poorest, 14960€ for richest). Controlling for health status and demographic variables, poor HIV patients consume more on pharmaceuticals; rich in specialists and hospital care. Therefore, there is inequity in health services utilization by socioeconomic groups. CONCLUSIONS: Equity in health provision for HIV patients represents a challenge even if access to treatment is guaranteed. Lack of information in poorer individuals might lead to under-provision while richer individuals might demand over-provision. We recommend establishing accurate clinical guidelines with the appropriate mix of health provision by validated need for all socioeconomic groups; promoting educational programs so that patients demand the appropriate mix of services, and stimulating integrated care for HIV patients with multiple chronic conditions. BioMed Central 2015-10-29 /pmc/articles/PMC4625850/ /pubmed/26510922 http://dx.doi.org/10.1186/s12939-015-0215-6 Text en © García-Goñi et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
García-Goñi, Manuel
Nuño-Solinís, Roberto
Orueta, Juan F.
Paolucci, Francesco
Is utilization of health services for HIV patients equal by socioeconomic status? Evidence from the Basque country
title Is utilization of health services for HIV patients equal by socioeconomic status? Evidence from the Basque country
title_full Is utilization of health services for HIV patients equal by socioeconomic status? Evidence from the Basque country
title_fullStr Is utilization of health services for HIV patients equal by socioeconomic status? Evidence from the Basque country
title_full_unstemmed Is utilization of health services for HIV patients equal by socioeconomic status? Evidence from the Basque country
title_short Is utilization of health services for HIV patients equal by socioeconomic status? Evidence from the Basque country
title_sort is utilization of health services for hiv patients equal by socioeconomic status? evidence from the basque country
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625850/
https://www.ncbi.nlm.nih.gov/pubmed/26510922
http://dx.doi.org/10.1186/s12939-015-0215-6
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