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        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Estimar la asociaci&#243;n de los ingresos econ&#243;micos del hogar y de la renta provincial con las consultas al medico general y al especialista y con la hospitalizaci&#243;n&#46; Estimar si el tiempo de espera para acceder a esos servicios var&#237;a con esas caracter&#237;sticas&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todo</span><p class="elsevierStyleSimplePara elsevierViewall">Datos de la Encuesta Nacional de Salud de 2001&#46; La asociaci&#243;n se estim&#243; mediante la <span class="elsevierStyleItalic">odds ratio</span>&#44; ajustada por edad y sexo&#44; y en el caso de la renta per c&#225;pita se ajust&#243; tambi&#233;n por los ingresos econ&#243;micos del hogar&#46; Se estimaron los percentiles y la media geom&#233;trica de los tiempos de espera en cada servicio sanitario y se evalu&#243; la significaci&#243;n estad&#237;stica de su asociaci&#243;n con ambas variables econ&#243;micas&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Los sujetos con menores ingresos econ&#243;micos presentan la mayor frecuencia de consultas al m&#233;dico general y hospitalizaci&#243;n&#44; aunque esperan m&#225;s tiempo para ser hospitalizados&#46; Estos sujetos presentan la menor frecuencia de consultas al especialista&#58; la <span class="elsevierStyleItalic">odds ratio</span> en el cuartil m&#225;s bajo de ingresos frente al m&#225;s alto fue 0&#44;73 &#40;intervalo de confianza del 95&#37;&#44; 0&#44;62-0&#44;87&#41;&#44; aunque en las consultas financiadas p&#250;blicamente la menor frecuencia se observa en los sujetos con mayores ingresos&#46; No se han encontrado diferencias en la utilizaci&#243;n y en los tiempos de espera seg&#250;n la renta provincial&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La frecuencia de consultas al especialista seg&#250;n los ingresos econ&#243;micos del hogar muestra un patron distinto al observado en las consultas al m&#233;dico general y en la hospitalizaci&#243;n&#46; El mayor tiempo de espera para hospitalizaci&#243;n se observa en los sujetos con menores ingresos econ&#243;micos&#46;</p>"
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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To estimate the association of household income and provincial income with visits to general practitioners and specialists and with hospitalization and to determine whether waiting times to access these services vary with both economic variables&#46;</p> <span class="elsevierStyleSectionTitle">Method</span><p class="elsevierStyleSimplePara elsevierViewall">Data from the 2001 National Health Survey were used&#46; The association was estimated by sex- and age-adjusted odds ratios&#59; in the case of per capita income&#44; odds ratios were also adjusted for household income&#46; Percentiles and the geometric mean of waiting times in each health service were estimated and the statistical significance of their association with both economic variables was evaluated&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Subjects with the lowest household income showed the highest frequency of visits to general practitioners and hospitalization&#44; although they waited longer for hospital admission&#46; Subjects with the lowest household income also showed the lowest frequency of specialist visits&#58; the odds ratio in the lowest income quartile with respect to the highest income quartile was 0&#46;73 &#40;95&#37; CI&#58; 0&#46;62-0&#46;87&#41;&#46; However&#44; when only visits to specialists working in the public system were analyzed&#44; the lowest frequency of visits was observed in subjects with the highest household income&#46; No differences were found in health services utilization or in waiting times according to provincial income&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The frequency of specialist visits according to household income shows a different pattern from that observed for visits to general practitioners and hospitalizations&#46; The longest waiting times for admission to hospital were observed in subjects with the lowest household income&#46;</p>"
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                      "titulo" => "Estimation of contribution of changes in coronary care to improving survival&#44; event rates&#44; and coronary heart disease mortality across the WHO MONICA Project populations"
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                      "titulo" => "Explanation for the Decline in Coronary Heart Disease Mortality Rates in Auckland&#44; New Zealand&#44; Between 1982 and 1993"
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                      "titulo" => "UK and USA breast cancer deaths down 25&#37; in year 2000 at ages 20-69 years"
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                      "titulo" => "Widening socioeconomic inequalities in mortality in six European countries"
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                            0 => "J&#46;P&#46; Mackenbach"
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                            2 => "O&#46; Andersen"
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                        "tituloSerie" => "Int J Epidemiol"
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Vol. 20. Núm. 5.
Páginas 352-359 (septiembre - octubre 2006)
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Vol. 20. Núm. 5.
Páginas 352-359 (septiembre - octubre 2006)
Originales
Open Access
Asociación de los ingresos económicos con la utilización y la accesibilidad de los servicios sanitarios en España al inicio del siglo XXI
Association of income with use of and access to health services in Spain at the beginning of the XXI century
Visitas
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Enrique Regidor
Autor para correspondencia
enriqueregidor@hotmail.com

Correspondencia: Dr. Enrique Regidor Departamento de Medicina Preventiva y Salud Pública. Facultad de Medicina. Universidad Complutense de Madrid. Ciudad Universitaria, s/n. 28040 Madrid. España.
, David Martínez, Paloma Astasio, Paloma Ortega, María Elisa Calle, Vicente Domínguez
Departamento de Medicina Preventiva y Salud Pública, Universidad Complutense de Madrid, España
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Objetivo

Estimar la asociación de los ingresos económicos del hogar y de la renta provincial con las consultas al medico general y al especialista y con la hospitalización. Estimar si el tiempo de espera para acceder a esos servicios varía con esas características.

Método

Datos de la Encuesta Nacional de Salud de 2001. La asociación se estimó mediante la odds ratio, ajustada por edad y sexo, y en el caso de la renta per cápita se ajustó también por los ingresos económicos del hogar. Se estimaron los percentiles y la media geométrica de los tiempos de espera en cada servicio sanitario y se evaluó la significación estadística de su asociación con ambas variables económicas.

Resultados

Los sujetos con menores ingresos económicos presentan la mayor frecuencia de consultas al médico general y hospitalización, aunque esperan más tiempo para ser hospitalizados. Estos sujetos presentan la menor frecuencia de consultas al especialista: la odds ratio en el cuartil más bajo de ingresos frente al más alto fue 0,73 (intervalo de confianza del 95%, 0,62-0,87), aunque en las consultas financiadas públicamente la menor frecuencia se observa en los sujetos con mayores ingresos. No se han encontrado diferencias en la utilización y en los tiempos de espera según la renta provincial.

Conclusiones

La frecuencia de consultas al especialista según los ingresos económicos del hogar muestra un patron distinto al observado en las consultas al médico general y en la hospitalización. El mayor tiempo de espera para hospitalización se observa en los sujetos con menores ingresos económicos.

Palabras clave:
Servicios sanitarios
Utilización
Accesibilidad a los servicios sanitarios
Ingresos económicos
Abstract
Objective

To estimate the association of household income and provincial income with visits to general practitioners and specialists and with hospitalization and to determine whether waiting times to access these services vary with both economic variables.

Method

Data from the 2001 National Health Survey were used. The association was estimated by sex- and age-adjusted odds ratios; in the case of per capita income, odds ratios were also adjusted for household income. Percentiles and the geometric mean of waiting times in each health service were estimated and the statistical significance of their association with both economic variables was evaluated.

Results

Subjects with the lowest household income showed the highest frequency of visits to general practitioners and hospitalization, although they waited longer for hospital admission. Subjects with the lowest household income also showed the lowest frequency of specialist visits: the odds ratio in the lowest income quartile with respect to the highest income quartile was 0.73 (95% CI: 0.62-0.87). However, when only visits to specialists working in the public system were analyzed, the lowest frequency of visits was observed in subjects with the highest household income. No differences were found in health services utilization or in waiting times according to provincial income.

Conclusions

The frequency of specialist visits according to household income shows a different pattern from that observed for visits to general practitioners and hospitalizations. The longest waiting times for admission to hospital were observed in subjects with the lowest household income.

Key words:
Health services
Utilization
Access to health care
Income
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