Differences that Hurt: Self-perceived Health Inequalities in Croatia and European Union

Autor: Zoran Šućur, Siniša Zrinšćak
Jazyk: angličtina
Rok vydání: 2007
Předmět:
Zdroj: Croatian Medical Journal
Volume 48.
Issue 5
ISSN: 1332-8166
0353-9504
Popis: Cilj Ispitati razlike u samoprocjeni stanja zdravlja i pristupačnosti zdravstvene zaštite različitih skupina stanovništa s obzirom na prihode i stupanj urbanizacije te njihovu područnu raspodjelu u Hrvatskoj i zemljama članicama Europske zejednice (EU). Postupci Podatci za zemlje EU preuzeti su iz Europske pismohrane podataka ankete o kvaliteti života (engl., European Quality of Life Survey database), koja je obuhvatila različite sastavnice kvalitete života, uključujući i zdravlje i zdravstvenu skrb. Anketa je provedena 2003., a obuhvatila je 28 zemalja, bez Hrvatske. U Hrvatskoj je provedena 2006. u okviru Razvojnog programa Ujedinjenih naroda za Hrvatsku (engl., United Nations Development Program Croatia). Zemlje Europske zajednice podijeljene su u dvije skupine: 15 „starih“, koje su se pridružile EU prije 15. svibnja 2004. i 10 „novih“, koje su tada primljene u EU. Istraženi su uzorci bili reprezentativni, a odnosili su se na osobe starije od 18 godina. Statističke razlike u stanju zdravlja i pristupačnosti zdravstvene skrbi između kategorija i skupina (prema prihodima, selo-grad, dijelovi Hrvatske) analizirane su χ2 testom ili analizom varijance. Rezultati Nađene su značajne razlike između 4 prihodne kvartile u Hrvatskoj i dvije skupine zemalja EU – u svim pokazateljima: samoprocjeni stanja zdravlja, zadovoljstvu vlastitim zdravljem, trpljenju dugotrajne bolesti ili nemoći, u četiri pokazatelja pristupačnosti zdravstvene skrbi (udaljenost od najbliže medicinske ustanove, odgađanje prijma, duljina čekanja liječnika na dan kad je pacijent naručen i cijene posjete liječniku), te naposljetku u kvaliteti zdravstvene usluge. Više je hrvatskih građana u najnižoj prihodovnoj kvartili izjavio je da je slaboga zdravlja (27.8%) nego njima prispodobive populacije u 15 „starih“ (9.2%) i 10 „novih“ (18.6%) zemalja. U Hrvatskoj je 26% ispitanika iz najniže prihodovne kvartile smatralo udaljenost do najbliže medicinske postaje vrlo ozbiljnim problemom, dok je to isto izjavilo 5.4% odgovarajućih osoba u EU15 i 9.4% u EU10. Omjer postotaka osoba u gradu i selu koje su smatrale da su slaboga zdravlja u Hrvatskoj je bio 80% viši nego u obje skupine zemalja EU. Omjer postotaka osoba u gradu i selu koje su smatrale da je cijena posjete liječniku ozbiljan problem u Hratskoj je bio skoro dvostruko viši nego u dvije skupine država EU. Zaključak Nejednakosti u pitanjima zdravlja bile su izraženije u Hrvatskoj nego u zemljama Europske zajednice, što je bitno držati na umu prilikom planiranja hrvatskih zdravstvenih reformi.
Aim To investigate the differences in self-reported health status and access to health care according to different income groups, urbanization level, and regional distribution in Croatia and European Union (EU) countries. Method Data for the EU countries were taken from the European Quality of Life Survey database, which examines different aspects of quality of life including health and health care. The survey was conducted in 2003 and covered 28 countries, although not Croatia. The survey in Croatia was conducted in 2006 by the United Nations Development Program Croatia. EU countries were divided into two groups – 15 “old” EU member states which joined the EU before May 2004 (EU15) and 10 new member states which joined the EU in May 2004 (NMS). The samples were representative and comprised persons aged 18 and over. Statistical differences in health status and access to health care between categories and groups (income groups, urban-rural divide, and analytical regions in case of Croatia) were tested by χ2 test or analysis of variance. Results Significant differences were found among 4 income quartiles in Croatia and two EU country groups in all indicators: self-perceived health status, satisfaction with health, having long-standing illness or disability, access to health care according to four indicators (distance to the nearest medical facility, delay in getting an appointment, waiting time to see the doctor on the day of the appointment, and the cost of seeing the doctor), and the quality of health services. Higher proportion of the Croatian citizens in the lowest income quartile reported poor health (27.8%) than their counterparts in the EU15 (9.2%) or NMS (18.6%). In Croatia, 26% respondents in the lowest quartile perceived the distance to the nearest medical facility as a very serious problem, compared with 5.4% in the EU15 and 9.4% in the NMS. Rural urban proportion ratio of those who reported poor health was about 80% higher in Croatia than in both EU country groups. Rural-urban proportion ratio of those who reported the cost of seeing the doctor as a very serious problem was almost 2-fold higher than in the two EU country groups. onclusion Health inequalities were more marked in Croatia than in EU countries, which should be taken into serious consideration in shaping health care reforms in Croatia.
Databáze: OpenAIRE
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