Assessing socioeconomic health care utilization inequity in Israel: impact of alternative approaches to morbidity adjustment
2011

Health Care Utilization Inequity in Israel

Sample size: 279241 publication 10 minutes Evidence: high

Author Information

Author(s): Shadmi Efrat, Balicer Ran D, Kinder Karen, Abrams Chad, Weiner Jonathan P

Primary Institution: Clalit Research Institute

Hypothesis

This study tests different approaches to morbidity adjustment in explanation of health care utilization inequity.

Conclusion

The study found that low socioeconomic status is linked to higher primary care usage but not to specialty care when adjusting for overall morbidity burden.

Supporting Evidence

  • Low socioeconomic status was associated with higher morbidity burden.
  • Persons of low socioeconomic status had greater odds of above average resource use for primary care and specialist visits.
  • Adjustment for overall morbidity burden showed that low socioeconomic status was no longer associated with greater odds of specialty care.

Takeaway

People with less money often go to the doctor more for regular check-ups but not for special treatments, which is surprising.

Methodology

The study used logistic regression models to analyze health care utilization among a representative sample of Clalit Health Services enrolees.

Potential Biases

Potential bias due to reliance on data registered during patient visits, which may miss non-clinically measured aspects of health.

Limitations

The measure of low SES is only a proxy and does not incorporate important information on education, income, and wealth components.

Participant Demographics

The sample included adults aged 18 or older, with a mean age of 45.8 years and 52% female.

Statistical Information

P-Value

p<0.001

Confidence Interval

CI: 0.94-0.99

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1186/1471-2458-11-609

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