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Decomposition of Healthcare Utilization Inequality in Iran: The Prominent Role of Health Literacy and Neighborhood Characteristics.

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Title: Decomposition of Healthcare Utilization Inequality in Iran: The Prominent Role of Health Literacy and Neighborhood Characteristics.
Authors: Soleimanvandiazar, Neda1 (AUTHOR), Mohaqeqi Kamal, Seyed Hossein2 (AUTHOR), Basakha, Mehdi2 (AUTHOR) Me.basakha@uswr.ac.ir, Karim, SalahEddin3 (AUTHOR), Ahmadi, Sina4 (AUTHOR), Ghaedamini Harouni, Gholamreza2 (AUTHOR), Sajjadi, Homeira2 (AUTHOR), Setareh Forouzan, Ameneh2 (AUTHOR)
Source: Inquiry (00469580). 2/9/2024, p1-11. 11p.
Subject Terms: *Research, *Health services accessibility, *Chronic diseases, *Research methodology, *Labor supply, *Comparative studies, Competency assessment (Law), Health policy, Human rights, Outpatient medical care, Scientific observation, Confidence intervals, Cross-sectional method, Health outcome assessment, Medical personnel, Health literacy, Primary health care, Patients' attitudes, Socioeconomic factors, Social classes, Psychosocial factors, Descriptive statistics, Chi-squared test, Health equity, Developing countries, Infant mortality, Odds ratio, Neighborhood characteristics, Insurance
Geographic Terms: Iran
Abstract: Unequal utilization in healthcare can potentially affect the right to health. Access to healthcare services and achieving positive health outcomes and health equity are essential principles in promoting human rights. This study aims to assess and analyze socioeconomic-related inequalities in outpatient health services utilization (OHSU) among various socio-demographic subgroups to inform policies that foster health equity. Data were collected through a cross-sectional survey of 1200 households in Tehran, Iran. Inequality in OHSU among the socio-demographic subgroups was calculated by concentration, Wagstaff, and Erigers indices. Decomposition was used to identify the factors contributing to inequality in OHSU. Marginal effect and elasticity were used to calculate the relative absolute shares of socio-demographic variables in the inequality. The rate of OHSU was 63.61% (CI: 60-66.80) which concentrated among households with better socioeconomic status. Based on the results, living in an affluent neighborhood (Relative share (RS): 85.48) and having a disabled member in the household (RS: 6.58) were the most important factors in the concentration of OHSU in favor of the privileged groups. In contrast, very low levels of health knowledge (RS: −83.79) and having basic insurance coverage (RS: −3.92) concentrated OHSU in favor of the lower socioeconomic households. The study was conducted based on survey data, and this may lead to some limitations. Given that this study was a cross-sectional study, we were unable to establish causal relationships between explanatory variables and outpatient health service utilization and its relevant predictors. Households with disabled member(s), as well as a member(s) with chronic diseases, may experience severe inequalities in access to healthcare services. Policies that facilitate access to health services for these households can play a significant role in improving health equity. [ABSTRACT FROM AUTHOR]
Copyright of Inquiry (00469580) is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Decomposition of Healthcare Utilization Inequality in Iran: The Prominent Role of Health Literacy and Neighborhood Characteristics.
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– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Unequal utilization in healthcare can potentially affect the right to health. Access to healthcare services and achieving positive health outcomes and health equity are essential principles in promoting human rights. This study aims to assess and analyze socioeconomic-related inequalities in outpatient health services utilization (OHSU) among various socio-demographic subgroups to inform policies that foster health equity. Data were collected through a cross-sectional survey of 1200 households in Tehran, Iran. Inequality in OHSU among the socio-demographic subgroups was calculated by concentration, Wagstaff, and Erigers indices. Decomposition was used to identify the factors contributing to inequality in OHSU. Marginal effect and elasticity were used to calculate the relative absolute shares of socio-demographic variables in the inequality. The rate of OHSU was 63.61% (CI: 60-66.80) which concentrated among households with better socioeconomic status. Based on the results, living in an affluent neighborhood (Relative share (RS): 85.48) and having a disabled member in the household (RS: 6.58) were the most important factors in the concentration of OHSU in favor of the privileged groups. In contrast, very low levels of health knowledge (RS: −83.79) and having basic insurance coverage (RS: −3.92) concentrated OHSU in favor of the lower socioeconomic households. The study was conducted based on survey data, and this may lead to some limitations. Given that this study was a cross-sectional study, we were unable to establish causal relationships between explanatory variables and outpatient health service utilization and its relevant predictors. Households with disabled member(s), as well as a member(s) with chronic diseases, may experience severe inequalities in access to healthcare services. Policies that facilitate access to health services for these households can play a significant role in improving health equity. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Inquiry (00469580) is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1177/00469580241229622
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 11
        StartPage: 1
    Subjects:
      – SubjectFull: Research
        Type: general
      – SubjectFull: Health services accessibility
        Type: general
      – SubjectFull: Chronic diseases
        Type: general
      – SubjectFull: Research methodology
        Type: general
      – SubjectFull: Labor supply
        Type: general
      – SubjectFull: Comparative studies
        Type: general
      – SubjectFull: Competency assessment (Law)
        Type: general
      – SubjectFull: Health policy
        Type: general
      – SubjectFull: Human rights
        Type: general
      – SubjectFull: Outpatient medical care
        Type: general
      – SubjectFull: Scientific observation
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Cross-sectional method
        Type: general
      – SubjectFull: Health outcome assessment
        Type: general
      – SubjectFull: Medical personnel
        Type: general
      – SubjectFull: Health literacy
        Type: general
      – SubjectFull: Primary health care
        Type: general
      – SubjectFull: Patients' attitudes
        Type: general
      – SubjectFull: Socioeconomic factors
        Type: general
      – SubjectFull: Social classes
        Type: general
      – SubjectFull: Psychosocial factors
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Chi-squared test
        Type: general
      – SubjectFull: Health equity
        Type: general
      – SubjectFull: Developing countries
        Type: general
      – SubjectFull: Infant mortality
        Type: general
      – SubjectFull: Odds ratio
        Type: general
      – SubjectFull: Neighborhood characteristics
        Type: general
      – SubjectFull: Insurance
        Type: general
      – SubjectFull: Iran
        Type: general
    Titles:
      – TitleFull: Decomposition of Healthcare Utilization Inequality in Iran: The Prominent Role of Health Literacy and Neighborhood Characteristics.
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              M: 02
              Text: 2/9/2024
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              Y: 2024
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