2016年9月
Inequality and inequity in healthcare utilization in urban Nepal: a cross-sectional observational study.
Health policy and planning
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- 巻
- 31
- 号
- 7
- 開始ページ
- 817
- 終了ページ
- 24
- 記述言語
- 英語
- 掲載種別
- 研究論文(学術雑誌)
- DOI
- 10.1093/heapol/czv137
- 出版者・発行元
- OXFORD UNIV PRESS
Inequality in access to quality healthcare is a major health policy challenge in many low- and middle-income countries. This study aimed to identify the major sources of inequity in healthcare utilization using a population-based household survey from urban Nepal. A cross-sectional survey was conducted covering 9177 individuals residing in 1997 households in five municipalities of Kathmandu valley between 2011 and 2012. The concentration index was calculated and a decomposition method was used to measure inequality in healthcare utilization, along with a horizontal inequity index (HI) to estimate socioeconomic inequalities in healthcare utilization. Results showed a significant pro-rich distribution of general healthcare utilization in all service providers (Concentration Index: 0.062, P < 0.001; HI: 0.029, P < 0.05) and private service providers (Concentration Index: 0.070, P < 0.001; HI: 0.030, P < 0.05). The pro-rich distribution of probability in general healthcare utilization was attributable to inequalities in the level of household economic status (percentage contribution: 67.8%) and in the self-reported prevalence of non-communicable diseases such as hypertension (36.7%) and diabetes (14.4%). Despite the provision of free services by public healthcare providers, our analysis found no evidence of the poor making more use of public health services (Concentration Index: 0.041, P = 0.094). Interventions to reduce the household economic burden of major illnesses, coupled with improvement in the management of public health facilities, warrant further attention by policy-makers.
- リンク情報
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- DOI
- https://doi.org/10.1093/heapol/czv137
- PubMed
- https://www.ncbi.nlm.nih.gov/pubmed/26856362
- PubMed Central
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4977425
- Web of Science
- https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000383901900001&DestApp=WOS_CPL
- URL
- http://www.scopus.com/inward/record.url?eid=2-s2.0-85021859244&partnerID=MN8TOARS 本文へのリンクあり
- Scopus Citedby
- https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85021859244&origin=inward
- ID情報
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- DOI : 10.1093/heapol/czv137
- ISSN : 0268-1080
- eISSN : 1460-2237
- ORCIDのPut Code : 92239569
- PubMed ID : 26856362
- PubMed Central 記事ID : PMC4977425
- SCOPUS ID : 85021859244
- Web of Science ID : WOS:000383901900001