Social inequalities in self-reported refraining from health care due to financial reasons in Sweden: health care on equal terms?

BMC Health Services Research

Hans G Eriksson⁴  Inna Feldman²  Marina Kalander-Blomqvist³  Margareta Lindén-Boström⁶  Bo Simonsson⁵  Anu Molarius¹ 

[1] Department of Public Health Sciences, Karlstad University, Karlstad, Sweden;Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden;Department of Public Health and Community Medicine, Värmland County Council, Karlstad, Sweden;Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden;Competence Centre for Health, Västmanland County Council, Västerås 721 89, Sweden;Department of Community Medicine and Public Health, Örebro County Council, Örebro, Sweden

关键词: Sweden;    Population surveys;    Inequalities;    Economic access;    Health care systems;   

Others  :  1090541
DOI  :  10.1186/s12913-014-0605-2

 received in 2014-08-21, accepted in 2014-11-17,  发布年份 2014

【 摘 要 】

Background

The main goal of the health care system in Sweden is good health and health care on equal terms for the entire population. This study investigated the existence of social inequalities in refraining from health care due to financial reasons in Sweden.

Methods

The study is based on 38,536 persons who responded to a survey questionnaire sent to a random sample of men and women aged 18-84 years in 2008 (response rate 59%). The proportion of persons who during the past three months due to financial reasons limited or refrained from seeking health care, purchasing medicine or seeking dental care is reported. The groups were defined by gender, age, country of origin, educational level and employment status. The prevalence of longstanding illness was used to describe morbidity in these groups. Differences between groups were tested with chi-squared statistics and multivariate logistic regression models.

Results

In total, 3% reported that they had limited or refrained from seeking health care, 4% from purchasing medicine and 10% from seeking dental care. To refrain from seeking health care was much more common among the unemployed (12%) and those on disability pension (10%) than among employees (2%). It was also more common among young adults and persons born outside the Nordic countries. Similar differences also apply to purchasing medicine and dental care. The odds for refraining from seeking health care, purchasing medicine or seeking dental care due to financial reasons were 2-3 times higher among persons with longstanding illness than among persons with no longstanding illness.

Conclusions

There are social inequalities in self-reported refraining from health care due to financial reasons in Sweden even though the absolute levels vary between different types of care. Often those in most need refrain from seeking health care which contradicts the national goal of the health care system. The results suggest that the fare systems of health care and dental care should be revised because they contribute to inequalities in health care.

【 授权许可】

   
2014 Molarius et al.; licensee BioMed Central Ltd.

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