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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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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. |
format | Online Article Text |
id | pubmed-4625850 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
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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