User fees impact access to healthcare for female children in rural Zambia.
J Trop Pediatr
; 48(6): 371-2, 2002 12.
Article
em En
| MEDLINE
| ID: mdl-12521282
ABSTRACT
The World Bank and International Monetary Fund favor healthcare user fees. User fees offer revenue and may decrease inappropriate care. However, user fees may deter needed care, especially in vulnerable populations. A cross-sectional analysis of healthcare utilization in a large Zambian hospital was conducted for children 3-6 years of age during a 1-month observation period. Diagnoses and treatments were compared using paired t-tests. Chi-squared tests compared outpatient service use. The relative risk of admission was determined for each stratum. Logistic models were developed to evaluate the impact of age, gender, and the age-gender interaction on hospital admissions. Trends suggest female children may be less likely to present for care when user fees are imposed. However, treatment type, treatment number, and number of diagnoses did not differ between genders. The relative risk of admission was highest for males 5-6 years old. Neither age nor gender alone was a significant determinant of hospital admission. However, the age-gender interaction was significant with female admissions least likely when costs were incurred. We conclude that user fees appear to decrease differentially utilization of inpatient care for female children in rural Zambia.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Honorários Médicos
/
Acessibilidade aos Serviços de Saúde
/
Hospitalização
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
Limite:
Child
/
Child, preschool
/
Female
/
Humans
/
Male
País/Região como assunto:
Africa
Idioma:
En
Ano de publicação:
2002
Tipo de documento:
Article