Brenda Gannon, Phyo Myat Aung, Aarushi Dhingra, Yaying Zhou
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引用次数: 0
Abstract
Background: This study investigates whether healthcare utilisation among older Australians is equitable, particularly focusing on people with cognitive decline from age 50. It investigates the economic concept of horizontal inequity in various types of healthcare use among older Australians and compares inequity among three groups: a representative sample of all individuals aged 50 and above, those with cognitive impairment, and individuals with a disability. Additionally, we examine changes in these patterns over time.
Methods and data: This study utilizes cross-sectional data for 2013 and 2017 from the Household, Income and Labour Dynamics in Australia (HILDA) survey to investigate four types of healthcare utilisation-general practitioner (GP), specialist, dental, and hospital admissions. We calculate the concentration index to measure the inequality and inequity in use. To quantify inequity, we correct for differences in needs and health status, following the indirect standardisation approach.
Results: Our findings suggest that among the three samples, the inequity faced by older Australians with cognitive impairment is the most pronounced. Individuals with higher socioeconomic status used dental care more, while GP visits were concentrated among the lower socioeconomic groups in 2013. By 2017, all types of healthcare except GP visits favour the better-off people (pro-rich). Among those with disabilities, we find a pro-rich distribution of dental care in both 2013 and 2017, and pro-rich inequity in the usage of specialist visits, even after adjusting for needs.
Conclusion: Pronounced disparities are observed among older people with cognitive impairment. Further targeting of policies to improve access to healthcare for older vulnerable Australians is recommended, to help achieve equitable and universal coverage in Australia.
期刊介绍：
International Journal for Equity in Health is an Open Access, peer-reviewed, online journal presenting evidence relevant to the search for, and attainment of, equity in health across and within countries. International Journal for Equity in Health aims to improve the understanding of issues that influence the health of populations. This includes the discussion of political, policy-related, economic, social and health services-related influences, particularly with regard to systematic differences in distributions of one or more aspects of health in population groups defined demographically, geographically, or socially.
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