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Country of birth, socioeconomic position, and health care expenditure― a multilevel analysis of the city of Malmö, Sweden

Beckman, Anders LU ; Merlo, Juan LU ; Lynch, J W; Gerdtham, Ulf LU ; Lindström, Martin LU and Lithman, T. (2004) In Journal of Epidemiology and Community Health 58(2). p.145-149
Abstract
Study objective: The principle of equity aims to guarantee allocation of healthcare resources on the basis of need. Therefore, people with a low income and persons living alone are expected to have higher healthcare expenditures. Besides these individual characteristics healthcare expenditure may be influenced by country of birth. This study therefore aimed to investigate the role of country of birth in explaining individual healthcare expenditure.

Design: Multilevel regression model based on individuals (first level) and their country of birth (second level).

Setting: The city of Malmö, Sweden.

Participants: All the 52 419 men aged 40–80 years from 130 different countries of birth, who were living in Malmö,... (More)
Study objective: The principle of equity aims to guarantee allocation of healthcare resources on the basis of need. Therefore, people with a low income and persons living alone are expected to have higher healthcare expenditures. Besides these individual characteristics healthcare expenditure may be influenced by country of birth. This study therefore aimed to investigate the role of country of birth in explaining individual healthcare expenditure.

Design: Multilevel regression model based on individuals (first level) and their country of birth (second level).

Setting: The city of Malmö, Sweden.

Participants: All the 52 419 men aged 40–80 years from 130 different countries of birth, who were living in Malmö, Sweden, during 1999.

Main results: At the individual level, persons with a low income and persons living alone showed a higher healthcare expenditure, with regression coefficients (and 95% confidence intervals) being 0.358 (0.325 to 0.392) and 0.197 (0.165 to 0.230), respectively. Country of birth explained a considerable part (18% and 13%) of the individual differences in the probability of having a low income and living alone, respectively. However, this figure was only 3% for having some health expenditure, and barely 0.7% with regard to costs in the 74% of the population with some health expenditure.

Conclusions: Malmö is a socioeconomically segregated city, in which the country of birth seems to play only a minor part in explaining individual differences in total healthcare expenditure. These differences seem instead to be determined by individual low income and living alone.
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Epidemiology and Community Health
volume
58
issue
2
pages
145 - 149
publisher
BMJ Publishing Group
external identifiers
  • pmid:14729898
  • wos:000188218900014
  • scopus:1642480245
ISSN
1470-2738
DOI
10.1136/jech.58.2.145http://dx.doi.org/10.1136/jech.58.2.145
language
English
LU publication?
yes
id
04e6dcb2-85ff-4252-8149-3e118ba7092e (old id 120070)
alternative location
http://jech.bmjjournals.com/cgi/content/abstract/58/2/145
date added to LUP
2007-07-11 16:14:38
date last changed
2017-12-11 09:01:37
@article{04e6dcb2-85ff-4252-8149-3e118ba7092e,
  abstract     = {Study objective: The principle of equity aims to guarantee allocation of healthcare resources on the basis of need. Therefore, people with a low income and persons living alone are expected to have higher healthcare expenditures. Besides these individual characteristics healthcare expenditure may be influenced by country of birth. This study therefore aimed to investigate the role of country of birth in explaining individual healthcare expenditure.<br/><br/>Design: Multilevel regression model based on individuals (first level) and their country of birth (second level).<br/><br/>Setting: The city of Malmö, Sweden.<br/><br/>Participants: All the 52 419 men aged 40–80 years from 130 different countries of birth, who were living in Malmö, Sweden, during 1999.<br/><br/>Main results: At the individual level, persons with a low income and persons living alone showed a higher healthcare expenditure, with regression coefficients (and 95% confidence intervals) being 0.358 (0.325 to 0.392) and 0.197 (0.165 to 0.230), respectively. Country of birth explained a considerable part (18% and 13%) of the individual differences in the probability of having a low income and living alone, respectively. However, this figure was only 3% for having some health expenditure, and barely 0.7% with regard to costs in the 74% of the population with some health expenditure.<br/><br/>Conclusions: Malmö is a socioeconomically segregated city, in which the country of birth seems to play only a minor part in explaining individual differences in total healthcare expenditure. These differences seem instead to be determined by individual low income and living alone.<br/>},
  author       = {Beckman, Anders and Merlo, Juan and Lynch, J W and Gerdtham, Ulf and Lindström, Martin and Lithman, T.},
  issn         = {1470-2738},
  language     = {eng},
  number       = {2},
  pages        = {145--149},
  publisher    = {BMJ Publishing Group},
  series       = {Journal of Epidemiology and Community Health},
  title        = {Country of birth, socioeconomic position, and health care expenditure― a multilevel analysis of the city of Malmö, Sweden},
  url          = {http://dx.doi.org/10.1136/jech.58.2.145http://dx.doi.org/10.1136/jech.58.2.145},
  volume       = {58},
  year         = {2004},
}