| Abstract | Cilj istraživanja: Nejednakosti u zdravlju nastaju radi nejednake raspodjele odrednica zdravlja, dostupnosti zdravstvene zaštite i korištenja zdravstvene zaštite. Cilj ovog rada je ukazati na postojanje razlika u korištenju zdravstvene zaštite između dvije populacijske skupine, izmjeriti i procijeniti nejednakosti u dostupnosti zdravstvenih usluga te povezati korištenje zdravstvene zaštite sa sociodemografskim, obrazovnim i osobnim značajkama ispitanika.
Ispitanici i metode: Istraživanje je provedeno tijekom 2010. godine, na 2.043 ispitanika koji su stanovnici Republike Hrvatske, u dobi od 25-65 godina, oba spola. Od toga 1.017 ispitanika pripada u skupinu socijalno depriviranih osoba, a 1.026 ispitanika su radno aktivni. Skupina radno aktivnih ispitanika obuhvaća osobe koje prema statističkim mjerilima, imaju dostatna sredstva za život, dok socijalno deprivirana skupina obuhvaća osobe koje su zbog nedostatnih financijskih sredstava za život primatelji novčane socijalne pomoći dulje od godinu dana. Podaci o zdravstvenom stanju, zdravstvenim rizicima, korištenju zdravstvene zaštite, dostupnosti zdravstvene zaštite te socioekonomskom statusu ispitanika prikupljeni su putem upitnika koji je kreiran za potrebe ovog istraživanja. Prikupljanje podataka provelo se terenskim istraživanjem sukladno propisanim etičkim načelima.
Rezultati: Ispitanici iz socijalno deprivirane skupine (ScD) opterećeniji su bolestima od ispitanika iz radno aktivne skupine (RA) u svim kategorijama (p<0,001). Nemogućnost pristupa zdravstvenim uslugama ispitali smo kroz dimenzije cijene i udaljenosti, te je za obje varijable otežavajuća okolnost korištenja zdravstvenih usluga za ispitanike ScD skupine. Utvrđene nedostupne zdravstvene usluge su pregled liječnika specijaliste (8,8% ScD u odnosu na 4,7% RA), nabavka potrebnih lijekova (11,4 % iz ScD u odnosu na 3,5% RA), usluge doktora dentalne medicine (9,3 % ScD u odnosu na 4,3% RA) te nabavka medicinskog pomagala (6,3% ScD u odnosu na 1,9% RA). Ispitanici iz ScD skupine su zadovoljniji dobivenom zdravstvenom zaštitom od ispitanika iz RA skupine, bez obzira na navedene poteškoće.
Zaključak: Nejednakosti u zdravstvenom stanju, korištenju zdravstvene zaštite te nemogućnosti korištenja iste prisutne su među populacijskim skupinama u Republici Hrvatskoj. Problem nejednakosti u zdravlju prelazi okvire medicinske problematike te predstavlja kompleksan izazov suvremenom društvu. Kontinuiranim praćenjem trenda nejednakosti i suradnjom različitih struka iz svih područja djelovanja u društvu mogu se postići rezultati u intervencijama s ciljem smanjivanja postojećih nejednakosti na najmanju moguću razinu |
| Abstract (english) | Objectives: Health inequalities appear because of uneven distribution of health determinants, health care availability or health care use. The aim of this paper is to give an account of health inequalities in the use of health services between two population groups, identify the reasons and services that are not available to the entire population as well as to relate health care use with socio-demographic, educational and personal characteristics of respondents.
Material and Methods: The research included 2.043 citizens of the Republic of Croatia, aged 25-62, of both genders, of which 1.017 were receivers of social support and 1.026 belonged to the working population. The socially disadvantaged group included people without sufficient resources for livelihood who have been receiving social support for longer than a year. The working group encompassed adults who have, according to the statistical standards, sufficient resources for living. The data regarding the health status, health risks, health care use, unavailability of health services and socio-economic status were obtained by a structured questionnaire. The data were collected by means of interviews in subject’s homes according to ethical principles.
Results: Respondents from the socially deprived group have a higher general morbidity in all examined categories (p<0,001). We investigated the lack of access to health care services with respect to price and distance and for both of these variables. Aggravating circumstances in the use of health care were seen in the socially deprived group compared to the working population. The unavailability of medical services included specialist examination (8.8 % of socially deprived group vs. 4.7% of the working group), procurement of necessary drugs (11.4 % of socially deprived group vs. 3.5% of the working group), availability of dental services (9.3 % of the socially deprived group vs. 4.3% of the working group) and the procurement of medical aids (6.3 % of socially deprived group vs. 1.9% of the working group). Socially deprived respondents are more satisfied with obtained health care irrespective of the stated problems.
Conclusion: Exploring two population groups of working capable adults in Croatia with and without sufficient resources for living, we found the existing differences in health status, health care use and health care availability. According to the results of this study, it is necessary to ensure a more appropriate and even allocation of health care resources taking into account the needs of groups of population with special needs. Likewise, it is necessary to continuously monitor the trends in inequality in order to assess the efficiency of interventions undertaken with the aim of reducing existing inequalities to the least possible measure. |
