Inequalities that hurt: demographic, socio-economic and health status inequalities in the utilization of health services in Serbia

Eur J Public Health. 2010 Aug;20(4):389-96. doi: 10.1093/eurpub/ckp189. Epub 2009 Nov 23.

Abstract

Background: The aim of this study was to analyse demographic, socio-economic and health status inequalities by gender in the utilization of health services in Serbia.

Methods: Data from 2006 National Health Survey for Serbia were used. A total of 14,522 persons from six geographical regions of Serbia aged >or=20 years were completely interviewed. Logistic regression analyses were used to study the effects of demographic (age, gender, marital status and type of settlement), socio-economic (education and Wealth Index) and health status (self-perceived health) variables on the utilization of health services [visits to general practitioner (GP), private doctor, dentist and hospitalization]. All analyses were carried out separately for males and females.

Results: As compared with women (reference category), a lower percentage of men visited a GP [odds ratio (OR) = 0.61; 95% confidence interval (95% CI) = 0.57-0.65], private doctor (OR = 0.62; 95% CI = 0.57-0.67) and dentist (OR = 0.81; 95% CI = 0.76-0.87), but there were no gender differences in hospitalization. Both males and females who belong to disadvantaged classes were less likely to have visited a GP, a private doctor or a dentist in 12 months before the interview, regardless of their health status. No inequalities by social class were observed for the hospitalization among persons with poor self-perceived health status, i.e. those in most need.

Conclusions: This study has shown that demographic, socio-economic and health status inequalities in the utilization of health services exist in Serbia. Wise health policy with equitable utilization of health services, regardless these inequalities should be a priority in shaping Serbian health care system reform.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Health Services / statistics & numerical data*
  • Health Status Disparities*
  • Health Surveys
  • Healthcare Disparities / economics*
  • Humans
  • Interviews as Topic
  • Logistic Models
  • Male
  • Middle Aged
  • Serbia
  • Sex Factors
  • Socioeconomic Factors*
  • Young Adult