¿Qué determina la elección público-privada en la sanidad española?

IF 1.1 Q4 HEALTH CARE SCIENCES & SERVICES
J. Rama-Caamaño , O. Iglesias Sousa , J. Rama
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Abstract

Introduction and objectives

The aim of the study was to analyze, which individual characteristics (sociodemographic, attitudinal and political factors) mediates in the choice in Spain in 2022, of a private versus public health care alternative for family doctor, doctor specialist, hospital admissions and emergencies.

Methods

Using the health barometers of the Centro de Investigaciones Sociológicas (CIS), we carried out four logistic regressions (then, average marginal effects [AMEs]) whose dependent variables are the preference for a private choice of family doctor versus a public one, the preference for a private choice of doctor specialist versus a public one; the preference for a private choice of hospital admission versus a public one and the preference for a private choice of emergency admission versus a public one. The dependent variables are binary (1 = private; 0 = public). The sample consisted of more than 4,500 individuals older than 18 years old distributed representatively throughout Spain.

Results

The probability of choosing private rather than public is correlated with the age of the individual: those over 50 years are less likely to opt for a private alternative (P < .01), as well as by ideology and satisfaction with the way that the national health system (NHS) works. Patients with a conservative ideology are more likely to choose private options (P < .01) and individuals with greater satisfaction with the NHS are less likely to choose private ones (P < .01).

Conclusions

Satisfaction with the NHS and patient ideology are the most relevant factors for private versus public choice.

是什么决定了西班牙医疗保健的公私选择?
介绍和目标本研究的目的是分析,哪些个人特征(社会人口、态度和政治因素)在2022年西班牙家庭医生、专科医生、住院和急诊的私人和公共医疗选择中起中介作用。方法使用调查中心Sociológicas (CIS)的健康指标,我们进行了四次logistic回归(然后,平均边际效应[AMEs]),其因变量是私人选择家庭医生的偏好与公共医生的偏好,私人选择专科医生的偏好与公共医生的偏好;对私立医院和公立医院的偏好以及对私立医院和公立医院的偏好。因变量为二进制(1 = private;0 =公共)。样本包括4500多名年龄在18岁以上的人,分布在西班牙各地。结果选择私人保险而不是公共保险的概率与个人的年龄相关:50岁以上的人不太可能选择私人保险(P <.01),以及意识形态和对国家卫生系统(NHS)运作方式的满意度。思想保守的患者更有可能选择私人选择(P <.01),对NHS更满意的个人不太可能选择私人机构(P <. 01)。结论对NHS的满意度和患者意识形态是影响私人选择与公共选择的最重要因素。
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来源期刊
CiteScore
1.70
自引率
8.30%
发文量
83
审稿时长
57 days
期刊介绍: Revista de Calidad Asistencial (Quality Healthcare) (RCA) is the official Journal of the Spanish Society of Quality Healthcare (Sociedad Española de Calidad Asistencial) (SECA) and is a tool for the dissemination of knowledge and reflection for the quality management of health services in Primary Care, as well as in Hospitals. It publishes articles associated with any aspect of research in the field of public health and health administration, including health education, epidemiology, medical statistics, health information, health economics, quality management, and health policies. The Journal publishes 6 issues, exclusively in electronic format. The Journal publishes, in Spanish, Original works, Special and Review Articles, as well as other sections. Articles are subjected to a rigorous, double blind, review process (peer review)
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