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Healthcare utilisation among the Belgian elderly in relation to their socio-economic status


  • Hoeck, Sarah
  • François, Guido
  • Van der Heyden, Johan
  • Geerts, Joanna
  • Van Hal, Guido


Objectives To analyse the association between healthcare utilisation of elderly persons (65 and over) in Belgium in terms of contacts with GP or specialist and the socio-economic indicators household income, highest educational level within the household, and housing tenure.Methods A cross-sectional study based on 4494 non-institutionalised elderly participants in the Belgian Health Interview Surveys of 2001 and 2004. Socio-economic gradients in contacts (yes or no) with a GP or specialist were explored, based on the socio-behavioural model of Andersen, a conceptual framework that includes the most important determinants of healthcare utilisation. Three multivariate models were constructed using multiple logistic regression.Results After adjustment for age, sex, health status (self-assessed health, functional restrictions, and comorbidity), region, and living situation, initial differences in contacts with a GP and specialist between the different socio-economic groups disappeared among the elderly. On the other hand, contacts with a specialist remain dependent on SES in the younger population.Conclusions Adjustment for the determinants of healthcare utilisation among the Belgian elderly nullified the socio-economic gradients in contacts with a GP and specialist that initially existed. The results point to a potential link with the Belgian social and health policy.

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  • 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.
  • Handle: RePEc:eee:hepoli:v:99:y:2011:i:2:p:174-182

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    References listed on IDEAS

    1. Lund, Rikke & Due, Pernille & Modvig, Jens & Holstein, Bjørn Evald & Damsgaard, Mogens Trab & Andersen, Per Kragh, 2002. "Cohabitation and marital status as predictors of mortality--an eight year follow-up study," Social Science & Medicine, Elsevier, vol. 55(4), pages 673-679, August.
    2. DE GRAEVE, Diana & DUCHESNE, I., 1997. "Equity in health and in medical care consumption in Belgium," SESO Working Papers 1997001, University of Antwerp, Faculty of Applied Economics.
    3. Oakes, J. Michael & Rossi, Peter H., 2003. "The measurement of SES in health research: current practice and steps toward a new approach," Social Science & Medicine, Elsevier, vol. 56(4), pages 769-784, February.
    4. Bago d'Uva, Teresa & Jones, Andrew M. & van Doorslaer, Eddy, 2009. "Measurement of horizontal inequity in health care utilisation using European panel data," Journal of Health Economics, Elsevier, vol. 28(2), pages 280-289, March.
    5. van Doorslaer, Eddy & Wagstaff, Adam & van der Burg, Hattem & Christiansen, Terkel & De Graeve, Diana & Duchesne, Inge & Gerdtham, Ulf-G & Gerfin, Michael & Geurts, Jose & Gross, Lorna, 2000. "Equity in the delivery of health care in Europe and the US," Journal of Health Economics, Elsevier, vol. 19(5), pages 553-583, September.
    6. Fernandez-Olano, C. & Hidalgo, J.D. Lopez-Torres & Cerda-Diaz, R. & Requena-Gallego, M. & Sanchez-Castano, C. & Urbistondo-Cascales, L. & Otero-Puime, A., 2006. "Factors associated with health care utilization by the elderly in a public health care system," Health Policy, Elsevier, vol. 75(2), pages 131-139, January.
    7. 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.
    8. Van der Heyden, J. H. A. & Demarest, S. & Tafforeau, J. & Van Oyen, H., 2003. "Socio-economic differences in the utilisation of health services in Belgium," Health Policy, Elsevier, vol. 65(2), pages 153-165, August.
    9. Habicht, Jarno & Kunst, Anton E., 2005. "Social inequalities in health care services utilisation after eight years of health care reforms: a cross-sectional study of Estonia, 1999," Social Science & Medicine, Elsevier, vol. 60(4), pages 777-787, February.
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    12. Dalstra, J.A.A. & Kunst, A.E. & Mackenbach, J.P., 2006. "A comparative appraisal of the relationship of education, income and housing tenure with less than good health among the elderly in Europe," Social Science & Medicine, Elsevier, vol. 62(8), pages 2046-2060, April.
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    1. repec:eee:joecag:v:6:y:2015:i:c:p:24-43 is not listed on IDEAS
    2. Sarah Hoeck & Johan Van der Heyden & Joanna Geerts & Guido Van Hal, 2013. "Equity in GP and specialist contacts by older persons in Belgium," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(4), pages 593-602, August.


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