Economic Inequality in the Healthcare Quality and its Decomposition Unequal distribution of Healthcare Quality
Bioethics and Health Law Journal (BHL),
Vol. 2 No. 1 (2022),
22 May 2022
,
Page 1-8 (e6)
https://doi.org/10.22037/bhl.v2i1.38954
Abstract
Background and Aim: Assessing the quality of the health care system is considered a basic step in the development of quality improvement programs. To date, no research has been conducted assessing the inequality in satisfaction with health care services in Iran using the assets. This study aimed to determine the satisfaction with healthcare services and determine the inequality of satisfaction with the quality of healthcare services.
Methods: This study was a descriptive-analytical survey of 844 people in Arak, multi-stage sampling was performed. The asset variables were used for Principal Component Analysis (PCA). In the present study, satisfaction with healthcare quality was a categorical variable. All analysis was conducted using STATA 12.0, and a P-value lower than 0.05 was taken to show statistical significance.
Ethical Considerations: After the explanation of the study objectives, written informed consent was obtained from all participants.
Results: Mean age of the participants was 33 ± 10.4 years. The level of satisfaction with the quality of health care services was that of agreed. Satisfaction with the quality of health services among people with higher socioeconomic status is more concentrated and statistically significant. The percentage of illiteracy in inequality is 84.18 percent.
Conclusion: Lower-than-high-school education can reduce inequality. Being single, living in rural areas, and having old age can decrease inequality. Among the variables, lower socioeconomic status has the largest contribution to inequality of satisfaction with health care. The results of the study revealed a significant inequality in the quality of health services in such a way that satisfaction with the quality of health care is significantly concentrated among the people with higher socioeconomic status. Decomposition of inequality index indicated that education level, age, gender, place of residence, marital status, and socioeconomic status play a significant role in the formation of this inequality, the largest contribution of which is attributable to socioeconomic status.
Corresponding Author: Rahmatollah Moradzadeh; Email: moradzadehr@yahoo.com; ORCID: https://orcid.org/0000-0003-4952-3454
Please cite this article as: Sharahi N, Taheri M, Moradzadeh R. Economic Inequality in the Healthcare Quality and its Decomposition. Bioeth Health Law J. 2022; 2(1): 1-8 (e6). http://doi.org/10.22037/bhl.v2i1.38954
- Economic Inequality
- Healthcare Quality
- Concentration index
- Decomposition
- Iran
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References
2. Bashiru I.I. Saeed, Munyakazi Louis, Eric N. Aidoo, Nicholas. N.N. Nsowah-Nuamah, Alfred E. Yawson, Zhao X. Socio-economic Inequalities and Healthcare Utilization in Ghana. International Journal of Business and Social Research. 2013;3(1):54-63.
3. Lim PC, Tang NKH. A study of patients’ expectations and satisfaction in Singapore hospitals. International Journal of Health Care Quality Assurance. 2000;13(7):290-9.
4. Naidu A. Factors affecting patient satisfaction and healthcare quality. International Journal of Health Care Quality Assurance. 2009;22(4):366-81.
5. Asaria M, Doran T, Cookson R. The costs of inequality: whole-population modelling study of lifetime inpatient hospital costs in the English National Health Service by level of neighbourhood deprivation. Journal of Epidemiology and Community Health. 2016.
6. Gong CH, Kendig H, He X. Factors predicting health services use among older people in China: An analysis of the China Health and Retirement Longitudinal Study 2013. BMC Health Services Research. 2016;16:63.
7. Mohammadbeigi A, Hassanzadeh J, Eshrati B, Rezaianzadeh A. Decomposition of inequity determinants of healthcare utilization, Iran. Public Health. 2013;127(7):661-7.
8. Hosseinpoor AR, Van Doorslaer E, Speybroeck N, Naghavi M, Mohammad K, Majdzadeh R, et al. Decomposing socioeconomic inequality in infant mortality in Iran. International Journal of Epidemiology. 2006;35(5):1211-9.
9. Hassanzadeh J, Mohammadbeigi A, Eshrati B, Rezaianzadeh A, Rajaeefard A. Determinants of Inequity in Health Care Services Utilization in Markazi Province of Iran. Iranian Red Crescent Medical Journal. 2013;15(5):363-70.
10. Mohammadbeigi A, Hassanzadeh J, Eshrati B, Rezaianzadeh A. Socioeconomic inequity in health care utilization, Iran. Journal of epidemiology and global health. 2013;3(3):139-46.
11. Owen O’Donnell, Eddy van Doorslaer, Adam Wagstaff, Magnus Lindelow. Analyzing Health Equity Using Household Survey Data. A Guide to Techniques and Their Implementation. Washington, DC: The International Bank for Reconstruction and Development / The World Bank; 2008.
12. Moradzadeh R, Nadrian H, Golboni F, Kazemi-Galougahi MH, Moghimi N. Socioeconomic inequalities amongst women with osteoporosis-related fractures: an Application of Concentration Index Decomposition. Health Promotion Perspectives. 2016;6(4):190-5.
13. Ayubi E, Sani M, Safiri S, Morasae EK, Almasi-Hashiani A, Nazarzadeh M. Socioeconomic Determinants of Inequality in Smoking Stages A Distributive Analysis on a Sample of Male High School Students. American journal of men's health. 2015:1557988315585822.
14. Bilger M, Kruger EJ, Finkelstein EA. Measuring Socioeconomic Inequality in Obesity: Looking Beyond the Obesity Threshold. Health Economics. 2016.
15. Cabieses B, Pickett KE, Wilkinson RG. the Impact of Socioeconomic Inequality on Children’s Health and Well-being. The Oxford Handbook of Economics and Human Biology. 2016:244.
16. Hashiani AA, Ayubi E, Fahimfar N, Khosravi A, Karamzad N, Safiri S. Economic Inequality and Infant, Under-5-Year-Old, Maternal, and Crude Mortality Rates. Journal of Archives in Military Medicine. 2015;3(3).
17. Khang Y-H, Kim H-R. Socioeconomic Inequality in mortality using 12-year follow-up data from nationally representative surveys in South Korea. International journal for equity in health. 2016;15(1):1.
18. Morasae EK, Forouzan AS, Majdzadeh R, Asadi-Lari M, Noorbala AA, Hosseinpoor AR. Understanding determinants of socioeconomic inequality in mental health in Iran's capital, Tehran: a concentration index decomposition approach. International journal for equity in health. 2012;11(1):1.
19. Mosquera PA, San Sebastian M, Waenerlund A-K, Ivarsson A, Weinehall L, Gustafsson PE. Income-related inequalities in cardiovascular disease from mid-life to old age in a Northern Swedish cohort: A decomposition analysis. Social Science & Medicine. 2016;149:135-44.
20. Saito E, Gilmour S, Yoneoka D, Gautam GS, Rahman MM, Shrestha PK, et al. Inequality and inequity in healthcare utilization in urban Nepal: a cross-sectional observational study. Health policy and planning. 2016:czv137.
21. Elwell-Sutton TM, Jiang CQ, Zhang WS, Cheng KK, Lam TH, Leung GM, et al. Inequality and inequity in access to health care and treatment for chronic conditions in China: the Guangzhou Biobank Cohort Study. Health policy and planning. 2013;28(5):467-79.
22. Leung GM, Tin KY, O'Donnell O. Redistribution or horizontal equity in Hong Kong's mixed public–private health system: a policy conundrum. Health economics. 2009;18(1):37-54.
23. Doorslaer Ev, Koolman X, Jones AM. Explaining income‐related inequalities in doctor utilisation in Europe. Health economics. 2004;13(7):629-47.
24. Moradzadeh R, Mansournia MA, Baghfalaki T, Ghiasvand R, Noori-Daloii MR, Holakouie-Naieni K. Misclassification Adjustment of Family History of Breast Cancer in a Case-Control Study: a Bayesian Approach. Asian Pacific Journal of Cancer Prevention. 2015;16(18):8221-6.
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