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

• Published in: International journal of environmental research and public health 2018-01, Vol.15 (1), p.121
• Main Authors: La Parra-Casado, Daniel, Mosquera, Paola A, Vives-Cases, Carmen, San Sebastian, Miguel
• Format: Article
• Language: English
• Subjects: Chronic Disease - epidemiology; Chronic illnesses; Citizenship; Community health care; Disease; Emergency medical services; Emergency Service, Hospital - statistics & numerical data; Emergency services; Employment; Epidemiology; ethnic groups; Fairness; Health care; Health care policy; Health services; Health Services - statistics & numerical data; Health Surveys; healthcare disparities; Hospitalization; Humans; Inequality; Population; Populations; Prevalence; Preventive medicine; Public health; Response rates; Roma; Roma - statistics & numerical data; Romani people; social class; Social classes; Socioeconomic Factors; Socioeconomics; Spain; Spain - epidemiology; Urban areas
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph15010121

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 ( = 21,650) and the 2014 National Health Survey of the Spanish Roma Population ( = 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.