Can patient self-management explain the health gradient? Goldman and Smith (2002) revisited: a response to Maitra.
نویسندگان
چکیده
In their much-cited paper, "Can patient self-management help explain the SES health gradient?"Goldman and Smith (2002) use samples of diabetic and HIV+ patients in the United States to conclude that disease self-management is an important explanation for the much-documented positive gradient in education and health outcomes. In this paper, I revisit their analysis and point to some fundamental difficulties in interpreting their results as conclusive evidence in favor of self-management. I also argue that for individuals for whom self-management might be expected to matter -i.e. populations of patients managing complex conditions - economic factors such as resource availability and insurance access might be a more important mechanism behind the gradient than medical compliance. The impact of self-management, though it might matter, is likely to be small.
منابع مشابه
Can patient self-management help explain the SES health gradient?
There are large differences in health outcomes by socioeconomic status (SES) that cannot be explained fully by traditional arguments, such as access to care or poor health behaviors. We consider a different explanation-better self-management of disease by the more educated. We examine differences by education in treatment adherence among patients with two illnesses, diabetes and HIV, and then a...
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عنوان ژورنال:
- Social science & medicine
دوره 70 6 شماره
صفحات -
تاریخ انتشار 2010