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Læknablaðið - 15.10.2011, Qupperneq 22

Læknablaðið - 15.10.2011, Qupperneq 22
RANNSÓKN Heimildir 1. Heilbrigðis- og tryggingamálaráðuneytið. Heilbrigðis- áætlun til ársins 2010: Langtímamarkmið í heilbrigðis- málum. Heilbrigðis- og tryggingamálaráðuneytið, Reykja- vík 2001. 2. Vilhjálmsson R. íslenska heiibrigðiskerfið á krossgötum. í: Jóhannesson G., ritstj. Rannsóknir í félagsvísindum VIII. Félagsvísindastofnun, Reykjavík 2007:197-206. 3. Cockerham WC. Medical sociology, llth ed.: Prentice- Hall, Upper Saddle River, NJ 2010. 4. Aday LA, Fleming GV, Andersen R. Access to medical care in the US: Who has it, who doesn't? Pluribus Press, Chicago, IL1984. 5. Vilhjálmsson R, Ólafsson Ó, Sigurðsson JÁ, Herbertsson TÞ (2001). Aðgangur að heilbrigðisþjónustu á íslandi. Landlæknisembættið, Reykjavík 2001. www.landlaeknir. is/Uploads/FileGallery/Utgafa/utg_adgangur01.pdf - mars 2011. 6. Adams PF, Benson V. Current estimates from the National Health Interview Survey, 1991. National Center for Health Statistics, Hyattsville, MD 1992. 7. Marcus AC, Siegel JM. Sex differences in the use of physician services: A preliminary test of the fixed role hypothesis. J Health Soc Behav 1982; 23:186-97. 8. Benzeval M, Judge K. Access to health care in England: continuing inequalities in the distribution of GPs. J Public Health Med 1996; 18:33-40. 9. Eyles J, Birch S, Newbold KB. Delivering the goods? Access to family physician services in Canada: a comparison of 1985 and 1991. J Health Soc Behav 1995; 36: 322-32. 10. Sharp K, Ross CE, Cockerham WC. Symptoms, beliefs, and the use of physician services among the disadvantaged. J Health Soc Behav 1983; 24: 255-63. 11. Evandrou M, Falkingham J, Le Grand J, Winter D. Equity in health and social care. J Soc Policy 1992; 21:489-523. 12. Aday LA, Andersen RM. Equity of access to medical care: a conceptual and empirical overview. í: President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research: securing access to health care. Vol. 3. Govemment Printing Office, Washington, DC 1983:19-54. 13. Berk ML, Schur CL, Cantor JC. Ability to obtain health care: recent estimates from the Robert Wood Johnson Foundation National Access to Care survey. Health Aff 1995; 14:139-46. 14. Gerdtham UG, Sundberg G. Equity in the delivery of health care in Sweden. Scand J Public Health 1998; 26: 259-64. 15. van Doorslaer E, Koolman X, Puffer F. Equity in the use of physician visits in OECD countries: has equal treatment for equal need been achieved? í: Measuring up: improving health systems performance in OECD countries. OECD, Paris, France 2002: 225-48. 16. Dunlop S, Coyte PC, Mclssac W. Socioeconomic status and the utilisation of physicians' services: results from the Canadian National Population Health Survey. Soc Sci Med 2000; 51; 123-33. 17. Schofield D. Ancillary and specialist health services: the relationship between income, user rates and equity of access. Aust J Soc Issues 1999; 1: 79-96. 18. Strauss AL, Corbin J, Fagerhaugh S, et al. Chronic illness and the quality of life. Mosby, St. Louis, MO 1984. 19. Vilhjálmsson R. Failure to seek needed medical care: results from a national health survey of Icelanders. Soc Sci Med 2005; 61:1320-30. 20. Vilhjálmsson R, Jörundsdóttir E, Sigurðardóttir H, Jóhannsdóttir ÞB. Þættir tengdir aðgengi að læknisþjónustu á íslandi. í: Sveinsdóttir H, Nyysti A, ritstj. Framtíðarsýn innan heilsugæsluhjúkrunar. Rannsóknastofnun í hjúkrunarfræði og Háskólaútgáfan, Reykjavík 2001: 70-94. 21. Nemet GF, Bailey AJ. Distance and health care utilization among the rural elderly. Soc Sci Med 2000; 50:1197-208. 22. Vilhjálmsson R. Landskönnunin Heilbrigði og aðstæður íslendinga - Aðferð og framkvæmd. Hjúkrunarfræðideild Háskóla íslands, Reykjavík 2007. 23. Vilhjálmsson R. Bein útgjöld íslenskra heimila vegna heilbrigðismála. Læknablaðið 2009; 95:661-8. 24. Vilhjálmsson R, Kristjánsdóttir G, Sveinbjamardóttir E. Factors associated with suicide ideation in adults. Soc Psychiatry Psychiatr Epidemiol 1998; 33:97-103. 25. Dillman DA. The design and administration of mail surveys. Annu Rev Sociol 1991; 17: 225-49. 26. Dutton DB. Social class, health and illness. í: Aiken LH, Mechanic D, ritstj. Applications of social science to clinical medicine and health policy. Rutgers University Press, New Brunswick, NJ 1986. 27. Baruch Y, Holtom BC. Survey response rate levels and trends in organizational research. J Hum Relations 2008; 61:1139-60. ENGLISH SUMMARY Postponement and cancellation of physician visits among lcelanders: Extent and explanations Vilhjálmsson R Objective: Equal access to health care is a central goal in socialized health systems like the one in lceland. Previous research in lceland indicates considerable individual and group differences in access to health care. The study maps the distribution of postponement and cancellation of physician care among lcelandic adults and considers a number of potential explanations. Material and methods: The data come from a national postal health survey of lcelandic adults, age 18-75, who were randomly drawn from the National Register. 1532 individuals responded to the survey yielding a 60% response rate. Results: 22% of the respondents had postponed or cancelled a physician visit they thought they needed in the past 6 months. The study found considerable variations in postponement rates. Postponement was positively related to younger age, full employment, financial difficulties, high out-of- pocket health care costs, inflexible daily schedules (fixed roles), dissatisfaction with last physician visit, and the number of chronic medical conditions experienced. Conclusions: Postponement or cancellation of medical care is fairly common among lcelandic adults, although considerable individual and group differences in postponement are observed. The results raise concerns, as equal access to care is a central goal of the lcelandic heaith care system. It is incumbent upon health authorities to pursue effective ways to equalize access to medical care and prevent postponement and cancellation of needed services. Key words: cancellation of medical care, access to health care, health services utilization, group differences. Correspondence: Rúnar Vilhjálmsson, runarv@hi.is 534 LÆKNAblaðið 2011/97
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