Inequalities that hurt: demographic, socio-economic and health status inequalities in the utilization of health services in Serbia.
BACKGROUND
The aim of this study was to analyse demographic, socio-economic and health status inequalities by gender in the utilization of health services in Serbia.


METHODS
Data from 2006 National Health Survey for Serbia were used. A total of 14,522 persons from six geographical regions of Serbia aged >or=20 years were completely interviewed. Logistic regression analyses were used to study the effects of demographic (age, gender, marital status and type of settlement), socio-economic (education and Wealth Index) and health status (self-perceived health) variables on the utilization of health services [visits to general practitioner (GP), private doctor, dentist and hospitalization]. All analyses were carried out separately for males and females.


RESULTS
As compared with women (reference category), a lower percentage of men visited a GP [odds ratio (OR) = 0.61; 95% confidence interval (95% CI) = 0.57-0.65], private doctor (OR = 0.62; 95% CI = 0.57-0.67) and dentist (OR = 0.81; 95% CI = 0.76-0.87), but there were no gender differences in hospitalization. Both males and females who belong to disadvantaged classes were less likely to have visited a GP, a private doctor or a dentist in 12 months before the interview, regardless of their health status. No inequalities by social class were observed for the hospitalization among persons with poor self-perceived health status, i.e. those in most need.


CONCLUSIONS
This study has shown that demographic, socio-economic and health status inequalities in the utilization of health services exist in Serbia. Wise health policy with equitable utilization of health services, regardless these inequalities should be a priority in shaping Serbian health care system reform.
Janković
Janko
J
Institute of Social Medicine, School of Medicine, University of Belgrade, Belgrade, Serbia. drjankojankovic@yahoo.com
Simić
Snezana
S
Marinković
Jelena
J
D000328:Adult; D000368:Aged; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006306:Health Surveys; D054625:Healthcare Disparities / Q000191:economics*; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D055771:Serbia; D012737:Sex Factors; D012959:Socioeconomic Factors; D055815:Young Adult