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[Use of specialist health care by the population]
Tor Iversen1, Gry Stine Kopperud
1Helseøkonomisk forskningsprogram, Universitetet i Oslo (HERO) Senter for helseadministrasjon, Rikshospitalet 0027 Oslo. tor.iversen@samfunnsmed.uio.no
Background:
Equitable use of specialist health care is a central goal of Norwegian health policy. It is, however, claimed that use of health care facilities are more determined by easy access than by need; hence that equity is not achieved. This article examines the impact on the use of health services of self-assessed health on the one hand and degree of access on the other.
Material And Methods:
Data from a national survey of quality of life were merged with data on capacity/access to primary and specialist health care. The data sets include individual characteristics of 3,449 persons. Binominal logistic analysis was applied.
Results:
When compared to persons with self-assessed poor or very poor health, those with self-assessed medium-level health are less likely to use hospital inpatient and outpatient services, but not less likely to use private specialists. Furthermore, we find significant effects of accessibility on the utilization of private specialists, but not on hospitalization.
Interpretation:
Use of hospital services is rationed according to patients' health status, and not affected by patients' access, as aimed at in national health policy. On the other hand, the use of private specialists seems to function as an alternative to general practitioner. The finding represents a challenge for national health policy.