越南城乡老年人医疗保健服务利用差异:来自全国调查的证据。

IF 2.3 4区 医学 Q3 HEALTH CARE SCIENCES & SERVICES
Thuy Tien Ngoc Doan, Long Thanh Giang
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引用次数: 0

摘要

本研究比较了生活在越南城市和农村的老年人的医疗保健服务利用情况,并确定了导致他们差异的关键因素。2019年,对3049名越南老年人进行了全国代表性的抽样研究,采用多元逻辑回归和泊松回归来确定影响服务利用概率和频率的因素。采用标准浓度指数(CI)和Erreygers浓度指数(EI)来衡量差异。采用扩展的瓦哈卡-布林德分解来检验城乡在医疗保健服务利用方面的差异,并量化造成差异的因素。ci和ei相对较小,接近于零,这意味着住院服务利用率和门诊服务利用率在所有家庭财富五分位数中分布均匀,无论其居住地点如何。Oaxaca-Blinder分解分析结果显示,农村和城市老年人在门诊服务利用的概率和频率方面存在统计学差异。农村居民的门诊使用率比城市居民低4.9%。同样,农村居民的门诊使用率比城市居民低3.033倍。医疗期间医疗保险的使用和健康状况不佳是解释老年人医疗保健利用城乡差异的两个重要决定因素。根据这些重要发现,建议继续发展医疗保险计划和投资,以支持农村老年人口获得医疗保健。未来的研究机会包括探索对这一领域更全面的理解,例如检查影响医疗机构选择的因素,报销率,以及城乡老年人的自付费用。此外,建议进行纵向研究,以调查越南老年人医疗保健服务利用的因果关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Differences in Healthcare Services Utilization Between Urban and Rural Older Persons in Vietnam: Evidence from a National Survey.

Differences in Healthcare Services Utilization Between Urban and Rural Older Persons in Vietnam: Evidence from a National Survey.

Differences in Healthcare Services Utilization Between Urban and Rural Older Persons in Vietnam: Evidence from a National Survey.

Differences in Healthcare Services Utilization Between Urban and Rural Older Persons in Vietnam: Evidence from a National Survey.

This research compared healthcare services utilization among older persons living in urban and rural Vietnam and determined the key factors contributing to their differences. A nationally representative sample of 3,049 older Vietnamese people in 2019 was used with multivariate logistic regressions and Poisson regressions to identify factors influencing the probability and frequency of service utilization. The standard concentration index (CI) and Erreygers concentration index (EI) were applied to measure the differences. The extension of the Oaxaca-Blinder decomposition was used to examine the rural-urban differences in healthcare services utilization and quantify factors contributing to the differences. CIs and EIs were relatively small and nearly zero, meaning that both inpatient service utilization and outpatient service utilization were equally distributed across all household wealth quintiles, regardless of their residence of living. Oaxaca-Blinder decomposition analysis results revealed statistically significant differences between rural and urban older persons in outpatient service utilization, in terms of its probability and frequency. Rural persons had 4.9% lower in the probability of outpatient services utilization than their urban counterparts. Similarly, rural residents had 3.033 times lower in the frequency of outpatient services utilization than urban residents. The use of health insurance during medical treatments and poor health status were two significant determinants explaining the urban-rural differences in healthcare utilization among older adults. Based on the crucial findings, continual development of the health insurance scheme and investment is recommended to support the rural older population in accessing healthcare. Future research opportunities include exploring a more comprehensive understanding of this field, such as examining the factors influencing the choice of healthcare facilities, reimbursement rates, and out-of-pocket expenses for older individuals in urban and rural areas. Additionally, longitudinal studies are recommended to investigate causal relationships in healthcare service utilization among older Vietnamese.

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来源期刊
CiteScore
2.50
自引率
0.00%
发文量
192
审稿时长
>12 weeks
期刊介绍: INQUIRY is a peer-reviewed open access journal whose msision is to to improve health by sharing research spanning health care, including public health, health services, and health policy.
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