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Int. J. Environ. Res. Public Health 2018, 15(1), 121; https://doi.org/10.3390/ijerph15010121

Socioeconomic Inequalities in the Use of Healthcare Services: Comparison between the Roma and General Populations in Spain

1
Department of Sociology 2, Alicante University, 03690 Alicante, Spain
2
Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden
3
Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Alicante University, 03690 Alicante, Spain
4
CIBER of Epidemiology and Public Health, Av. Monforte de Lemos, 3-5. Pabellón 11. Planta 0, 28029 Madrid, Spain
5
Department of Nursing I, University of the Basque Country, 48940 Bilbao, Spain
*
Author to whom correspondence should be addressed.
Received: 5 December 2017 / Revised: 30 December 2017 / Accepted: 5 January 2018 / Published: 12 January 2018
(This article belongs to the Special Issue Roma Health)
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Abstract

This paper explores whether the principles of horizontal and vertical equity in healthcare are met by the Spanish national health system in the case of the Roma and general populations. The 2011/2012 Spanish National Health Survey (n = 21,650) and the 2014 National Health Survey of the Spanish Roma Population (n = 1167) were analyzed. Use of healthcare services was measured in terms of visits to a general practitioner (GP), visits to an emergency department, and hospitalizations. Healthcare need was measured using (a) self-rated health and (b) the reported number of chronic diseases. The Roma reported worse self-rated health and a higher prevalence of chronic diseases. A redistributive effect (increased healthcare service use among Roma and those in lower socio-economic classes) was found for hospitalizations and emergency visits. This effect was also observed in GP visits for women, but not for men. Vertical inequity was observed in the general population but not in the Roma population for GP visits. The results suggest the existence of horizontal inequity in the use of GP services (Roma women), emergency department visits (Roma and general population), and hospitalizations (Roma population) and of vertical inequity in the use of GP services among the general population. View Full-Text
Keywords: ethnic groups; social class; Roma; healthcare disparities; Spain ethnic groups; social class; Roma; healthcare disparities; Spain
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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La Parra-Casado, D.; Mosquera, P.A.; Vives-Cases, C.; San Sebastian, M. Socioeconomic Inequalities in the Use of Healthcare Services: Comparison between the Roma and General Populations in Spain. Int. J. Environ. Res. Public Health 2018, 15, 121.

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