Article
The quality of care and influence of double health care coverage
in Catalonia (Spain)
Luis Rajmila, Carme Borrellb, Barbara Starfieldc, Esteve Fernandeza, Vicky Serraa, Anna Schiaffinoa, Andreu Seguraa
a Institut
Universitari de Salut Pública de Catalunya, Campus de Bellvitge,
Universitat de Barcelona, Ctra Feixa Llarga s/n, 08907 L'Hospitalet
(Barcelona), Catalonia, Spain, b Institut Municipal de Salut Pública de
Barcelona, Spain, c Johns Hopkins
University, Baltimore, Maryland, USA
Correspondence to: Dr Rajmil email: lrajmil{at}bellvitge.bvg.ub.es
Accepted 22 May 2000
AIMS
To analyse inequalities
by social class in children's access to and utilisation of health
services in Catalonia (Spain), private health insurance coverage, and
certain aspects of the quality of care received.
DESIGNCross sectional study using
data from the 1994 Catalan Health Interview Survey.
SETTINGChild population of Catalonia.
PARTICIPANTSA representative
sample of non-institutionalised children younger than 15 years
(n = 2433).
MAIN OUTCOME MEASURESHealth
services utilisation, perceived health, type of health insurance (only
National Health System (NHS) or both NHS and private health insurance),
and social class.
RESULTSNo inequalities by social
class were found for the utilisation of health care services provided
by the NHS among children in most need. Double health care coverage
does not influence the social pattern of visits. Nevertheless, social
inequalities still remain in the use of those health services provided
only partially by the NHS (dentist) and when characteristics of the
last consultation are taken into account. That is, subjects who paid
for a private service waited an average of 14.8 minutes less than those
whose visit was paid for by the NHS only.
CONCLUSIONEquitable access and use
of medical care services in relation to need, regardless of the type of
insurance and social class of their children and families, has been
achieved in this region of Spain; differences by social class remain
for those services incompletely covered by national health insurance
and aspects of the quality of care provided.
Keywords: social inequalities; health care utilisation; quality of care; health interview survey
© 2000 by Archives of Disease in Childhood
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This article has been cited by other articles:
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Berra, S., Borrell, C., Rajmil, L., Estrada, M.-D., Rodriguez, M., Riley, A. W., Forrest, C. B., Starfield, B.
(2006). Perceived health status and use of healthcare services among children and adolescents. Eur J Public Health
16: 405-414
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