IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0196673.html
   My bibliography  Save this article

Variations in diagnostic testing utilization in Italy: Secondary analysis of a national survey

Author

Listed:
  • Pamela Barbadoro
  • Antonella D’Alleva
  • Sara Galmozzi
  • Gemma Zocco
  • Francesco Di Stanislao
  • Emilia Prospero
  • Marcello Mario D’Errico

Abstract

Background: According to the principle of horizontal equity, individuals with similar need may have the same possibility of access to health services. The aim of this study is to identify patterns of diagnostic services utilization, in people with, and without chronic disease in Italy. Methods: Secondary analysis of data from the national survey on Health and use of health care in Italy, carried out in 2013, including 99,497 participants. Multilevel analysis has been used to study the variables associated to diagnostic services utilization. Results: 13.78% of participants have had one diagnostic testing in the four weeks before the interview. In healthy people, utilization of diagnostic testing is reduced in people with low educational level (OR 0.75; 95%CI 0.67–0.84), in housewives (OR 0.66; 95%CI 0.51–0.87), or in those unable to work (OR 0.48; 95%CI 0.26–0.87), while increased in those perceiving a worse health status (up to OR 4.00, 95%CI 2.00–8.01 in very bad health). In people afflicted with chronic disease, access to diagnostic assessment is impaired by educational level (OR 0.69; 95%CI 0.61–0.78) and low household income (OR 0.75; 95%CI 0.58–0.97), while it is increased in the presence of a ticket exemption (OR 1.55, 95%CI 1.42–1.68), and fixed-term occupation (OR2.28, 95%CI 1.31–3.95). Being former-smokers in associated to an increased utilization of services in both groups. Conclusions: Despite a universal and theoretically egalitarian, public, health care system, variations in diagnostic services utilization are still registered in Italy, both in healthy people and those afflicted by chronic diseases, on socio-economic/occupational basis, and self-perceived health status. Moreover, this significant effect of occupation on healthcare utilization, suggests the need for a comprehensive evaluation of economics in occupational health.

Suggested Citation

  • Pamela Barbadoro & Antonella D’Alleva & Sara Galmozzi & Gemma Zocco & Francesco Di Stanislao & Emilia Prospero & Marcello Mario D’Errico, 2018. "Variations in diagnostic testing utilization in Italy: Secondary analysis of a national survey," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-13, June.
    • Handle: RePEc:plo:pone00:0196673
    DOI: 10.1371/journal.pone.0196673
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0196673
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0196673&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0196673?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Luisa Franzini & Margherita Giannoni, 2009. "Determinants of Health Disparities in Italian Regions," Quaderni del Dipartimento di Economia, Finanza e Statistica 70/2009, Università di Perugia, Dipartimento Economia.
    2. Jeremy Hurst & Melissa Jee-Hughes, 2001. "Performance Measurement and Performance Management in OECD Health Systems," OECD Labour Market and Social Policy Occasional Papers 47, OECD Publishing.
    3. Tony J Culyer & Alan Wagstaff, 1991. "Need, equality and social justice," Working Papers 090chedp, Centre for Health Economics, University of York.
    4. Lu, Jui-fen R. & Leung, Gabriel M. & Kwon, Soonman & Tin, Keith Y.K. & Van Doorslaer, Eddy & O'Donnell, Owen, 2007. "Horizontal equity in health care utilization evidence from three high-income Asian economies," Social Science & Medicine, Elsevier, vol. 64(1), pages 199-212, January.
    5. Dunlop, Sheryl & Coyte, Peter C. & McIsaac, Warren, 2000. "Socio-economic status and the utilisation of physicians' services: results from the Canadian National Population Health Survey," Social Science & Medicine, Elsevier, vol. 51(1), pages 123-133, July.
    6. Anthony J. Culyer (ed.), 1991. "The Economics Of Health," Books, Edward Elgar Publishing, volume 0, number 541.
    7. Denton, Margaret & Prus, Steven & Walters, Vivienne, 2004. "Gender differences in health: a Canadian study of the psychosocial, structural and behavioural determinants of health," Social Science & Medicine, Elsevier, vol. 58(12), pages 2585-2600, June.
    8. Salway, Sarah & Mir, Ghazala & Turner, Daniel & Ellison, George T.H. & Carter, Lynne & Gerrish, Kate, 2016. "Obstacles to “race equality” in the English National Health Service: Insights from the healthcare commissioning arena," Social Science & Medicine, Elsevier, vol. 152(C), pages 102-110.
    9. Terraneo, Marco, 2015. "Inequities in health care utilization by people aged 50+: Evidence from 12 European countries," Social Science & Medicine, Elsevier, vol. 126(C), pages 154-163.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Prus, Steven G., 2011. "Comparing social determinants of self-rated health across the United States and Canada," Social Science & Medicine, Elsevier, vol. 73(1), pages 50-59, July.
    2. Chaofan Li & Lei Dou & Haipeng Wang & Shanshan Jing & Aitian Yin, 2017. "Horizontal Inequity in Health Care Utilization among the Middle-Aged and Elderly in China," IJERPH, MDPI, vol. 14(8), pages 1-13, July.
    3. Wei Yang & Julien Forder & Olena Nizalova, 2017. "Measuring the productivity of residential long-term care in England: methods for quality adjustment and regional comparison," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(5), pages 635-647, June.
    4. Clark, Derek, 1995. "Priority setting in health care: An axiomatic bargaining approach," Journal of Health Economics, Elsevier, vol. 14(3), pages 345-360, August.
    5. Zhao, Guangchuan & Cao, Xinbang & Ma, Chao, 2020. "Accounting for horizontal inequity in the delivery of health care: A framework for measurement and decomposition," International Review of Economics & Finance, Elsevier, vol. 66(C), pages 13-24.
    6. Hongyun Zhou & Jiqing Hong & Su Yang & Yuxuan Huang, 2022. "The Impact of Social Capital on Rural Residents’ Medical Service Utilization in China—An Empirical Study Based on CFPS Data," IJERPH, MDPI, vol. 19(23), pages 1-19, November.
    7. Hoeck, Sarah & François, Guido & Van der Heyden, Johan & Geerts, Joanna & Van Hal, Guido, 2011. "Healthcare utilisation among the Belgian elderly in relation to their socio-economic status," Health Policy, Elsevier, vol. 99(2), pages 174-182, February.
    8. Wong, Irene O.L. & Cowling, Benjamin J. & Lo, Su-Vui & Leung, Gabriel M., 2009. "A multilevel analysis of the effects of neighbourhood income inequality on individual self-rated health in Hong Kong," Social Science & Medicine, Elsevier, vol. 68(1), pages 124-132, January.
    9. Clémence Kieny & Gabriela Flores & Jürgen Maurer, 2021. "Assessing and decomposing gender differences in evaluative and emotional well-being among older adults in the developing world," Review of Economics of the Household, Springer, vol. 19(1), pages 189-221, March.
    10. Round, Jeff, 2012. "Is a QALY still a QALY at the end of life?," Journal of Health Economics, Elsevier, vol. 31(3), pages 521-527.
    11. Marina Vercelli & Roberto Lillini & Fabrizio Stracci & Valerio Brunori & Alessio Gili & Fortunato Bianconi & Francesco La Rosa & Alberto Izzotti & Elodie Guillaume & Guy Launoy, 2020. "Cancer Mortality and Deprivation: Comparison Among the Performances of the European Deprivation Index, the Italian Deprivation Index and Local Socio-Health Deprivation Indices," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 151(2), pages 599-620, September.
    12. Gyeong-Suk Jeon & Sung-Il Cho & Kyungwon Choi & Kwang-Sim Jang, 2019. "Gender Differences in the Prevalence and Correlates of Elder Abuse in a Community-Dwelling Older Population in Korea," IJERPH, MDPI, vol. 16(1), pages 1-13, January.
    13. Chen, Yuanyuan & Wang, Haining & Cheng, Zhiming & Smyth, Russell, 2023. "Education and Migrant Health in China," Economic Modelling, Elsevier, vol. 121(C).
    14. Kyungwon Choi & Gyeong-Suk Jeon & Kwang-Sim Jang, 2020. "Gender Differences in the Impact of Intergenerational Support on Depressive Symptoms among Older Adults in Korea," IJERPH, MDPI, vol. 17(12), pages 1-13, June.
    15. Fritzell, Sara & Ringbäck Weitoft, Gunilla & Fritzell, Johan & Burström, Bo, 2007. "From macro to micro: The health of Swedish lone mothers during changing economic and social circumstances," Social Science & Medicine, Elsevier, vol. 65(12), pages 2474-2488, December.
    16. Lee, Chioun & Ryff, Carol D., 2016. "Early parenthood as a link between childhood disadvantage and adult heart problems: A gender-based approach," Social Science & Medicine, Elsevier, vol. 171(C), pages 58-66.
    17. Kirsi Talala & Taina Huurre & Hillevi Aro & Tuija Martelin & Ritva Prättälä, 2008. "Socio-demographic Differences in Self-reported Psychological Distress Among 25- to 64-Year-Old Finns," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 86(2), pages 323-335, April.
    18. Chavas, Jean-Paul, 2013. "On Demand Analysis and Dynamics: A Benefit Function Approach," 2013 Annual Meeting, August 4-6, 2013, Washington, D.C. 149683, Agricultural and Applied Economics Association.
    19. Orfila, Francesc & Ferrer, Montserrat & Lamarca, Rosa & Tebe, Cristian & Domingo-Salvany, Antonia & Alonso, Jordi, 2006. "Gender differences in health-related quality of life among the elderly: The role of objective functional capacity and chronic conditions," Social Science & Medicine, Elsevier, vol. 63(9), pages 2367-2380, November.
    20. Han, Kyu-Tae & Park, Eun-Cheol & Kim, Sun Jung, 2016. "Unmet healthcare needs and community health center utilization among the low-income population based on a nationwide community health survey," Health Policy, Elsevier, vol. 120(6), pages 630-637.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0196673. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.