Assessing national and subnational inequalities in medical care utilization and financial risk protection in Rwanda.
Int J Equity Health
; 18(1): 51, 2019 03 27.
Article
em En
| MEDLINE
| ID: mdl-30917822
ABSTRACT
BACKGROUND:
Ensuring equitable access to medical care with financial risk protection has been at the center of achieving universal health coverage. In this paper, we assess the levels and trends of inequalities in medical care utilization and household catastrophic health spending (HCHS) at the national and sub-national levels in Rwanda.METHODS:
Using the Rwanda Integrated Living Conditions Surveys of 2005, 2010, 2014, and 2016, we applied multivariable logit models to generate the levels and trends of adjusted inequalities in medical care utilization and HCHS across the four survey years by four socio-demographic dimensions poverty, gender, education, and residence. We measured the national- and district-level inequalities in both absolute and relative terms.RESULTS:
At the national level, after controlling for other factors, we found significant inequalities in medical care utilization by poverty and education and -in HCHS by poverty in all four years. From 2005 to 2016, inequalities in medical care utilization by the four dimensions did not change significantly, while the inequality in HCHS by poverty was reduced significantly. At the district level, inequalities in both medical care utilization and HCHS were larger than zero in all four years and decreased over time.CONCLUSIONS:
Poverty and poor education were significant contributors to inequalities in medical care utilization and HCHS in Rwanda. Policies or interventions targeting poor households or households headed by persons receiving no education are needed in order to effectively reduce inequalities in medical care utilization and HCHS.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Aceitação pelo Paciente de Cuidados de Saúde
/
Doença Catastrófica
/
Gastos em Saúde
/
Participação no Risco Financeiro
/
Disparidades em Assistência à Saúde
Tipo de estudo:
Etiology_studies
/
Health_economic_evaluation
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Africa
Idioma:
En
Revista:
Int J Equity Health
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
China