Revista Española de Salud Pública
Print version ISSN 1135-5727
LOSTAO, Lourdes et al. Evolution of the socio-economic differences in the use and accessibility of health services in Spain between 1987 and 1995-97. Rev. Esp. Salud Publica [online]. 2001, vol.75, n.2, pp. 115-128. ISSN 1135-5727. http://dx.doi.org/10.1590/S1135-57272001000200004.
BACKGROUND: The objective of this study is to evaluate the trend in the use and accessibility of health services in Spain between 1987 and 1995-1997 in groups with different socio-economic characteristics. METHODS: The data used are taken from National Health Surveys carried out on the adult population in 1987 and 1995-97 by the Ministry of Health and Consumer Affairs. The information for 1995 and 1997 has been combined due to the different sample size, in such a way that the estimates so obtained are the mean from both years. Population analysed has been people aged 24 years and older. The following have been studied: visits to the doctor, hospitalization, visits to the dentist and the gynecologist, the time taken to reach the visits to the doctor, and the waiting time in both the visits to the doctor and ordinary hospital admission. The socio-economic characteristics used are the level of education and the socio-economic group of the respondents. The measure of the association calculated between use of services and the socio-economic characteristics was the percentage ratio estimated by binomial regression. In addition, the relative index of inequality was estimated as a global measure of inequality. RESULTS: Visits to the doctor were the most frequent factor in people without academic qualifications and the lower socio-economic group in the two periods, while visits to the dentist and the gynecologist were more frequent in the higher socio-economic groups in both periods. Statistically significant differences in the frequency of hospitalization in the two periods were not found. Neither in 1987 nor 1995/1997 were statistically significant differences found between the different socio-economic groups as regards the time taken to visits to the doctor (p>0,05), although there were in waiting time in visits to the doctor (p<0,05). In the second period the socio-economic differences observed in the first period in waiting time for ordinary hospital admission disappeared. CONCLUSIONS: In the second half of the 1990s the same socio-economic profile was observed in the use of health services and the time spent waiting to receive them, as in the second half of the 1980s, with the exception of waiting time for ordinary hospital admission in the second period.
Keywords : Use of services; Accessibility of health services; Evolution; Level of education; Socio-economic groups.