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- Title
Ability to pay and equity in access to Italian and British National Health Services.
- Authors
Domenighetti, Gianfranco; Vineis, Paolo; De Pietro, Carlo; Tomada, Angelo
- Abstract
Background: Equity in delivery and distribution of health care is an important determinant of health and a cornerstone in the long way to social justice. We performed a comparative analysis of the prevalence of Italian and British residents who have fully paid out-of-pocket for health services which they could have obtained free of charge or at a lower cost from their respective National Health Services. Methods: Cross-sectional study based on a standardized questionnaire survey carried out in autumn 2006 among two representative samples (n = 1000) of the general population aged 20–74 years in each of the two countries. Results: 78% (OR 19.9; 95% CI 15.5–25.6) of Italian residents have fully paid out-of-pocket for at least one access to health services in their lives, and 45% (OR 18.1; 95% CI 12.9–25.5) for more than five accesses. Considering only the last 2 years, 61% (OR 16.5; 95% CI 12.6–21.5) of Italians have fully paid out-of-pocket for at least one access. The corresponding pattern for British residents is 20 and 4% for lifelong prevalence, and 10% for the last 2 years. Conclusions: Opening the public health facilities to a privileged private access to all hospital physicians based on patient’s ability to pay, as Italy does, could be a source of social inequality in access to care and could probably represent a major obstacle to decreasing waiting times for patients in the standard formal ‘free of charge’ way of access.
- Subjects
UNITED Kingdom; NATIONAL health services; GREAT Britain. National Health Service; CROSS-sectional method; MEDICAL care research; MEDICAL care costs; HEALTH services accessibility; EQUALITY
- Publication
European Journal of Public Health, 2010, Vol 20, Issue 5, p500
- ISSN
1101-1262
- Publication type
Article
- DOI
10.1093/eurpub/ckq001