Возрастные и статусные неравенства неудовлетворенных потребностей в услугах здравоохранения: теоретические подходы и эмпирические факты
Аннотация
В статье представлен обзор современных зарубежных исследований, посвященных проблеме доступа к системе здравоохранения, его социальной структуризации и обусловленности общественным контекстом. В качестве основного индикатора доступности рассматривается субъективный показатель неудовлетворенной потребности в медицинской помощи. Исследования фокусируются на различиях в доступности, обусловленных социальной демографией и потребностью в медицинской помощи. Полученные факты свидетельствуют, что с возрастом и при повышении социально-экономического статуса неудовлетворенных потребностей в медицинской помощи становится, как правило, меньше. Было установлено также, что возрастные и статусные неравенства могут существенно варьироваться – они выше в одних странах и ниже в других. Все еще недостаточно внимания уделяется характеристикам систем здравоохранения, которые обеспечивают институциональный контекст для предоставления медицинской помощи. Исследования, посвященные изучению контекстуальных факторов, влияющих на статусные неравенства в неудовлетворенных медицинских потребностях, немногочисленны, а их результаты оказываются противоречивыми. Проблема возрастных неравенств остается практически неизученной как в отдельных странах, так и при межстрановом сопоставлении. В дальнейших исследованиях наиболее обещающим направлением является рассмотрение демографических и социальных неравенств в неудовлетворенных медицинских потребностях с учетом не только индивидуальных различий, но и их взаимодействия с факторами общественного контекста.
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