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How do socio-economic factors and distance predict access to prevention and rehabilitation services in a Danish municipality?

Authors: Hindhede, Anette Lykke; Bonde, Ane; Schipperijn, Jasper; Scheuer, Stine H; Sørensen, Susanne Margrethe; Aagaard-Hansen, Jens;

How do socio-economic factors and distance predict access to prevention and rehabilitation services in a Danish municipality?

Abstract

AimThe aim was to explore the extent to which a Danish prevention centre catered to marginalised groups within the catchment area. We determined whether the district’s socio-economic vulnerability status and distance from the citizens’ residential sector to the centre influenced referrals of citizens to the centre, their attendance at initial appointment, and completion of planned activities at the centre.BackgroundDisparities in access to health care services is one among many aspects of inequality in health. There are multiple determinants within populations (socio-economic status, ethnicity, and education) as well as the health care systems (resource availability and cultural acceptability).MethodsA total of 347 participants referred to the centre during a 10-month period were included. For each of 44 districts within the catchment area, the degree of socio-economic vulnerability was estimated based on the citizens’ educational level, ethnicity, income, and unemployment rate. A socio-economic vulnerability score (SE-score) was calculated. Logistic regression was used to calculate the probability that a person was referred to the centre, attended the initial appointment, and completed the planned activities, depending on sex, age, SE-score of district of residence, and distance to the centre.FindingsCitizens from locations with a high socio-economic vulnerability had increased probability of being referred by general practitioners, hospitals, and job centres. Citizens living further away from the prevention centre had a reduced probability of being referred by their general practitioners. After referral, there was no difference in probability of attendance or completion as a function of SE-score or distance between the citizens’ district and the centre. In conclusion, the centre is capable of attracting referrals from districts where the need is likely to be relatively high in terms of socio-economic vulnerability, whereas distance reduced the probability of referral. No differences were found in attendance or completion.

Keywords

Adult, Male, Rural Population, Preventive Medicine/statistics & numerical data, Denmark, Rehabilitation Centers, Health Services Accessibility, vulnerable areas, Pedagogic device, Ethnicity, Humans, Rural Population/statistics & numerical data, Referral and Consultation, Risk approach, Health Services Accessibility/statistics & numerical data, Rehabilitation, Middle Aged, Rehabilitation Centers/statistics & numerical data, Inequality, Socioeconomic Factors, Referral and Consultation/statistics & numerical data, Female, Preventive Medicine, Ethnicity/statistics & numerical data

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
6
Average
Average
Average
Green
gold