Socio-economic status as a determinant of access to paediatric health care in Poland

Tadeusz Zienkiewicz, Ewa Zienkiewicz

Abstract


Background: The work presented here attempts to determine does patients' socio-economic status affect the spatial diversity of access to paediatric healthcare in Poland. That is why the aim of this study was to identify the main factors that determine differences in the distribution and workload of paediatricians in Poland. In particular, to clarify the role of patients' socio-economic status in access to public paediatric health care. This research, specific to conditions in Poland, will contribute to the further development of knowledge in this field. Data were obtained from the Statistics Poland database. Principal component analysis of standardized attribute variables related to provinces and multivariate regression were used to identify factors of differences in paediatrician workload. Results: Two principal components were identified. The first, the level of socio-economic status, negatively correlated with the number of treated patients per paediatrician (-26.845, p=0.010). The second, the degree of urbanisation, presented a statistically insignificant positive correlation with the mentioned patients' number (3.946, p=0.664). Conclusions: The research suggests that socio-economic factors may affect the uneven spatial distribution of the workload of paediatricians in Poland and cause differences between the provinces in the equal access to paediatricians. This research may thus provide implications for policy and practice, as well as lead to a better understanding of the problem.


Keywords


socio-economic status; urbanisation; paediatricians; healthcare access; regional diversity

Full Text:

PDF

References


Baliński P., Krajewski R. Lekarze i lekarze dentyści w Polsce - charakterystyka demograficzna. Stan w dniu 31.12.2017r. Warszawa: NIL; 2018.

Bernheim S.M., Ross J.S., Krumholz H.M., Bradley E.H. Influence of patients’ socioeconomic status on clinical management decisions: a qualitative study. “Ann Fam Med.” 2008, vol. 6, pp.53–59, DOI: https:// 10.1370/afm.749

Clegg L.X., Reichman M.E., Miller B.A., et al. Impact of socioeconomic status on cancer incidence and stage at diagnosis: selected findings from the surveillance, epidemiology, and end results: National Longitudinal Mortality Study. “Cancer Causes Control” 2009; vol. 20, pp. 417–435, DOI: https:// doi: 10.1007/s10552-008-9256-0.

Coocson, R., Propper, C., Asaria, M., Raine, R. Socio-Economic Inequalities in Health Care in England. “Fiscal studies” 2016, vol. 37(3-4), pp. 371–403, DOI: https://doi.org/10.1111/j.1475-5890.2016.12109

Decker S.L. Medicaid physician fees and the quality of medical care of Medicaid patients in the USA. “Rev Econ Househ.” 2007, vol. 5, pp. 95-112.

Domagała A., Dubas-Jakóbczyk K. Migration intentions among physicians working in Polish hospitals - Insights from survey research. “Health Policy” 2019, vol. 8, pp.782–789.

GUS. Knowledges databases. 2019. Available at: http://swaid.stat.gov.pl/SitePages/StronaGlownaDBW.aspx. Accessed June 29, 2019.

Hing E., Decker S.L., Jamoom E. Acceptance of New Patients With Public and Private Insurance by Office-Based Physicians: United States, 2013. “NCHS Data Brief” 2015, vol. 195, pp. 1–8.

Hsu C.C., Lee C.H., Wahlqvist M.L., et al. Poverty increases type 2 diabetes incidence and inequality of care despite universal health coverage. “Diabetes Care” 2012, vol. 35, pp. 2286–2292, DOI: https://doi: 10.2337/dc11-2052

Kangovi S., Barg F.K., Carter T., Long J.A., Shannon R., Grande D. Understanding Why Patients Of Low Socioeconomic Status Prefer Hospitals Over Ambulatory Care. “Health Affairs” 2013, vol. 32(7), pp. 1196–1203, DOI: https://doi:10.1377/hlthaff.2012.0825

Lasser K.E., Himmelstein D.U, Woolhandler S. Access to Care, Health Status, and Health Disparities in the United States and Canada: Results of a Cross-National Population-Based Survey. “Am J Public Health” 2006, vol. 96(7), pp. 1300-1307, DOI: https://10.2105/AJPH.2004.059402

Meyers D.S., Mishori R., McCann J., et al. Primary care physicians’ perceptions of the effect of insurance status on clinical decision making. “Ann Fam Med.” 2006, vol. 4, pp. 399–402, DOI: https:// 10.1370/afm.574

Murdoch A. Emigracja lekarzy z Polski. Warszawa: SGH; 2011.

Newacheck P.W., Hung Y.Y., Park M.J., Brindis C.D., Irwin C.E. Disparitities in adolescent health and health care: Does socioeconomic status matter? “Health Services Research” 2003, vol. 38(5), pp. 1235–1252, DOI: https:// doi:10.1111/1475-6773.00174

OECD. Health at a Glance 2021: OECD Indicators, OECD Publishing, Paris, 2021, DOI: https://doi.org/10.1787/ae3016b9-en.

Penchansky R., Thomas J.W. The concept of access: definition and relationship to consumer satisfaction. “Med Care” 1981, vol. 19(2), pp. 127-140.

Riley W.J., Health Disparities: Gaps in Access, Quality and Affordability of Medical Care, “Trans Am Clin Climatol Assoc.” 2012, vol. 123, pp. 167–174,

The website of Mp.pl, Dla pacjentów, https://www.mp.pl/pacjent/pediatria/aktualnosci/badania/183022,dola-pediatry

The website of Puls Medycyny, https://pulsmedycyny.pl/polska-ma-najmniej-lekarzy-w-calej-unii-europejskiej-977230

Thomas, J.W., Penchansky, R. Relating satisfaction with access to utilization of services. “Med Care” 1984, vol. 22(6), pp. 553-568.

Tille F., Gibis B., Balke K., Kuhlmey A., Schnitzer S. Sociodemographic and health-related determinants of health care utilisation and access to primary and specialist care: Results of a nationwide population survey in Germany (2006-2016). “Z Evid Fortbild Qual Gesundhwes” 2017, vol. 126, pp.52-65, DOI: https:// 10.1016/j.zefq.2017.07.012

van Ryn M., Burke J. The effect of patient race and socioeconomic status on physicians’ perceptions of patients, “SocSci Med.” 2000, vol. 50, pp. 813–828, DOI: https://doi.org/10.1016/S0277-9536(99)00338-X

Washington Health Alliance. Disparities in Care 2014 Report. Seattle, WA: Washington Health Alliance.

Wynia M.K., VanGeest J.B., Cummins D.S., Wilson I.B. Do physicians not offer useful services because of coverage restrictions? “Health Aff (Millwood).” 2003, vol. 22, pp. 190-197, DOI: https:// 10.1377/hlthaff.22.4.190

Zienkiewicz E., Zienkiewicz T., Dziaduch S. Regional differences in access to health care in Poland from the perspective of health care resources. “Annals of Agricultural and Environmental Medicine” 2018, vol. 1, pp.77–81. DOI: https://doi.org/10.5604/12321966.1235169

LEGAL ACTS

Sejm of the Republic of Poland. Act of 27 August 2004 on health care services financed from public funds. Dz.U. 2018, item 151. 2004

Sejm RP. Act of 11 February 2016 on state aid in child rearing. Dz.U. 2016 item 195. 2016.




DOI: http://dx.doi.org/10.17951/bc.2021.6.49-61
Date of publication: 2022-01-17 11:21:11
Date of submission: 2021-12-19 16:45:10


Statistics


Total abstract view - 885
Downloads (from 2020-06-17) - PDF - 503

Indicators



Refbacks

  • There are currently no refbacks.


Copyright (c) 2022

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.