Inequalities in preventive cardiovascular service use in persons with functional limitations
P Đurić, V Jovanović, M Živković Šulović, D Dukić, M Vasić, N Rajović, A Stevanović, B ĐikanovićAbstract
Background
Persons with functional limitations (FLs) are at increased risk of cardiovascular diseases (CVD) and may face barriers to accessing preventive health care. This study examines the preventive cardiovascular services (PCS) use and factors influencing their utilization among persons with FLs in Serbia.
Methods
A cross-sectional study was conducted using data from the European Health Interview Survey 2019 conducted in Serbia. Of 13,178 respondents, a total of 1,487 with FLs had complete outcome data and were included in the analysis. The outcome was defined as PCS uptake: reported measurement of blood pressure, blood glucose, and cholesterol within the past year by a healthcare worker. Independent variables were socioeconomic factors, self-perceived health, presence of chronic diseases (CDs), CVD, and body mass index. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated using univariable and multivariable logistic regression.
Results
Among 1,487 respondents, 1,009 (67.9%) reported having all three PCS utilization in the past year. Independent factors associated with PCS uptake were socioeconomic status, self-perceived health, presence of CD, and history of myocardial infarction. Compared to the lowest socioeconomic group, respondents in the middle and higher categories had 1.72 (95% CI: 1.18–2.50) and 2.08 (95% CI: 1.37–3.18) times higher odds of PCS use. Individuals with moderate self-perceived health had higher odds of PCS use than those reporting good health (OR = 1.77; 95% CI: 1.19–2.62). The presence of CD (OR = 1.55; 95% CI: 1.07–2.24) and myocardial infarction history (OR = 1.71; 95% CI: 1.26–2.31) were independently associated with PCS use.
Conclusions
PCS uptake among persons with FLs is influenced by socioeconomic inequalities and health status, indicating need-driven utilization. Lower PCS uptake among individuals with better self-perceived health may indicate opportunities to further strengthen proactive preventive approaches.
Key messages
• PCS use among persons with FL and CDs may reflect ongoing prevention of complications of existing CDs.
• Targeted health promotion strategies are needed to improve PCS use in lower socioeconomic groups with FLs.