Decomposition of socioeconomic inequalities of hypertension care utilization: Bangladesh experience

This paper investigates the socioeconomic determinants of the utilization of screening services and prescribed medication for hypertension in Bangladesh, aiming to address the significant burden of non-communicable diseases (NCDs) in the country. Drawing upon Andersen's theoretical framework of healthcare behavior, the analysis employs probit regression and concentration index methodologies on data from the 2017-18 Bangladesh Health and Demographic Survey. Results indicate that age, marital status, body mass index (BMI), smoking habit, and wealth status positively influence the utilization of screening services and treatment for hypertension. However, contradictory findings for education and employment suggest a nuanced relationship, possibly influenced by access to healthcare resources and time constraints. Concentration curve analysis reveals pro-rich inequality in both screening and treatment utilization, with the concentration index for screening services being statistically significant. Decomposition analysis further elucidates the contributions of specific factors to socioeconomic inequality, highlighting the importance of educational attainment and age in healthcare access. These findings underscore the need for targeted interventions aimed at addressing socioeconomic disparities in hypertension management, including efforts to improve access to healthcare resources, raise awareness, and mitigate barriers to healthcare access among marginalized populations. Addressing these disparities is crucial for promoting equitable healthcare delivery and reducing the burden of hypertension and related NCDs in Bangladesh.