Social capital and administrative contextual determinants of lack of access to a regular doctor: A multilevel analysis in southern Sweden.

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Standard

Harvard

APA

CBE

MLA

Vancouver

Author

RIS

TY - JOUR

T1 - Social capital and administrative contextual determinants of lack of access to a regular doctor: A multilevel analysis in southern Sweden.

AU - Lindström, Martin

AU - Axén, Elin

AU - Lindström, Christine

AU - Beckman, Anders

AU - Moghaddassi, Mahnaz

AU - Merlo, Juan

N1 - The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Division of Social Medicine and Global Health (013241820), Psychiatry/Primary Care/Public Health (013240500), Social Epidemiology (013241850), Centre for Economic Demography (012019200)

PY - 2006

Y1 - 2006

N2 - Background The aim of this study was to investigate the influence of contextual (social capital and administrative/neo-materialist) and individual factors on lack of access to a regular doctor. Methods The 2000 public health survey in Scania is a cross-sectional study. A total of 13,715 persons answered a postal questionnaire, which is 59% of the random sample. A multilevel logistic regression model, with individuals at the first level and municipalities at the second, was performed. The effect (intra-class correlations, cross-level modification and odds ratios) of individual and municipality (social capital and health care district) factors on lack of access to a regular doctor was analysed using simulation method. The Deviance Information Criterion (DIC) was used as information criterion for the models. Results The second level municipality variance in lack of access to a regular doctor is substantial even in the final models with all individual and contextual variables included. The model that results in the largest reduction in DIC is the model including age, sex and individual social participation (which is a network aspect of social capital), but the models which include administrative and social capital second level factors also reduced the DIC values. Conclusions This study suggests that both administrative health care district and social capital may partly explain the individual's self reported lack of access to a regular doctor.

AB - Background The aim of this study was to investigate the influence of contextual (social capital and administrative/neo-materialist) and individual factors on lack of access to a regular doctor. Methods The 2000 public health survey in Scania is a cross-sectional study. A total of 13,715 persons answered a postal questionnaire, which is 59% of the random sample. A multilevel logistic regression model, with individuals at the first level and municipalities at the second, was performed. The effect (intra-class correlations, cross-level modification and odds ratios) of individual and municipality (social capital and health care district) factors on lack of access to a regular doctor was analysed using simulation method. The Deviance Information Criterion (DIC) was used as information criterion for the models. Results The second level municipality variance in lack of access to a regular doctor is substantial even in the final models with all individual and contextual variables included. The model that results in the largest reduction in DIC is the model including age, sex and individual social participation (which is a network aspect of social capital), but the models which include administrative and social capital second level factors also reduced the DIC values. Conclusions This study suggests that both administrative health care district and social capital may partly explain the individual's self reported lack of access to a regular doctor.

KW - Health care district

KW - Social participation

KW - Social capital

KW - Multilevel

KW - Access

KW - Regular doctor

KW - Neo-materialism

U2 - 10.1016/j.healthpol.2005.12.001

DO - 10.1016/j.healthpol.2005.12.001

M3 - Article

VL - 79

SP - 153

EP - 164

JO - Health Policy

JF - Health Policy

SN - 1872-6054

IS - 2-3

ER -