Disparities in self-rated health, health care utilization, illness, chronic illness and other socioeconomic characteristics of the Insured and Uninsured 2804-2816
: Paul Andrew Bourne, Research Fellow, Department of Community Health and Psychiatry, the University of the West Indies, Mona, Kingston 7, St. Andrew, Jamaica, West Indies. Email: email@example.com. Tel.: (876) 457-6990. Fax: (876) 977-6346.
Background: Previous studies which have examined health status as regards the insured and the uninsured have used a piecemeal approach.
Aims: This study elucidates information on the self-rated health status, health care utilization, income distribution and health insurance status of Jamaicans. It also models self-rated health status, health care utilization and income distribution and how these differ between the insured and the uninsured.
Methods And Material: Cross-sectional data from the 2007 Jamaica Survey of Living Conditions (JSLC) were used to analyze the information for this study.
Statistical Analyses Used: The statistics were analyzed by using the Statistical Package for the Social Sciences for Windows, Version 16.0. Analytic models using multiple logistic and linear regressions were used to determine factors which explained self-rated health status, health care utilization and income distribution.
Result: The majority of health insurance was owned by those in the upper class, (65%), as compared to 19% for those in the lower socio-economic strata. No significant statistical difference was found between the average medical expenditure of those who had insurance coverage and the non-insured. Insured respondents were 1.5 times (Odds ratio, OR, 95% CI = 1.06 – 2.15) more likely to rate their health as moderate-to-very good as compared to the uninsured, and they were 1.9 times (95% CI = 1.31-2.64) more likely to seek medical care, 1.6 times (95% CI = 1.02-2.42) more likely to report having chronic illness and more likely to have greater income than the uninsured. Illness is a strong predictor of why Jamaicans seek medical care (R2 = 71.2%) and health insurance coverage accounted for less than half a percent of the variance in health care utilization. Health care utilization is a strong predictor of self-reported illness, but it was weaker than illness in explaining health care utilization (61.1% of 66.5%). Public health insurance was mostly acquired by those with chronic illnesses: (76%) as compared to 44% private health coverage and 38% without coverage.
Conclusion: The findings highlighted that any reduction in the health care budget in developing nations means that vulnerable groups will seek less care and this will further increase the mortality among those cohorts.