Background: The aim of this study was to analyse demographic, socio-economic and health status inequalities by gender in the utilization of health services in Serbia. Methods: Data from 2006 National Health Survey for Serbia were used. A total of 14 522 persons from six geographical regions of Serbia aged ≥20 years were completely interviewed. Logistic regression analyses were used to study the effects of demographic (age, gender, marital status and type of settlement), socio-economic (education and Wealth Index) and health status (self-perceived health) variables on the utilization of health services [visits to general practitioner (GP), private doctor, dentist and hospitalization]. All analyses were carried out separately for males and females. Results: As compared with women (reference category), a lower percentage of men visited a GP [odds ratio (OR) = 0.61; 95% confidence interval (95% CI) = 0.57–0.65], private doctor (OR = 0.62; 95% CI = 0.57–0.67) and dentist (OR = 0.81; 95% CI = 0.76–0.87), but there were no gender differences in hospitalization. Both males and females who belong to disadvantaged classes were less likely to have visited a GP, a private doctor or a dentist in 12 months before the interview, regardless of their health status. No inequalities by social class were observed for the hospitalization among persons with poor self-perceived health status, i.e. those in most need. Conclusions: This study has shown that demographic, socio-economic and health status inequalities in the utilization of health services exist in Serbia. Wise health policy with equitable utilization of health services, regardless these inequalities should be a priority in shaping Serbian health care system reform.

Objective: Cardiovascular health (CVH) is a relatively new concept defined by the American Heart Association (AHA). The aim of the present study was to assess whether the indices of CVH were discriminators of socioeconomic status (SES) in the adult population of the Republic of Srpska (RS). Design: Population-based cross-sectional study. Setting: RS, Bosnia and Herzegovina. Participants: The study involved 4165 adults aged ≥18 years (mean age 50.2; 54% women) who participated in the National Health Survey performed from September to November 2010 in the RS. Study variables: Participant's education was a proxy for SES. Potential discriminators of SES were indices of CVH presented according to AHA as: ideal health behaviours index (non-smoking, body mass index <25 kg/m ² , physical activity at goal level and healthy diet); ideal health factors index (untreated total cholesterol <200 mg/dL, untreated blood pressure <120/<80 mm Hg, untreated fasting glucose <100 mg/dL and non-smoking); and ideal CVH status (defined as all seven ideal health metrics present) versus intermediate and poor CVH status. Results: Participants with high educational levels had a significantly greater number of ideal CVH metrics, and ideal health factor metrics compared with those with low or medium educational level (OR 0.88 95% CI 0.77 to 0.99 and OR 0.88 95% CI 0.80 to 0.96; OR 0.81 95% CI 0.69 to 0.96 and OR 0.77 95% CI 0.68 to 0.87; respectively). The number of ideal behaviour metrics was not a discriminator of educational groups. Concerning the categories of CVH status the poor CVH was a discriminator for low and medium education compared with those with high education (OR 1.93 95% CI 1.24 to 3.01 and OR 1.54 95% CI 1.08 to 2.19, respectively). Conclusions: Our findings emphasise the large potential for preventing cardiovascular disease, showing a low proportion with a favourable CVH profile, especially among low-educated people. It is necessary to consider prevention strategies aimed at improving CVH in RS, targeting primarily low educational groups.

Keywords: Cardiovascular diseases; Metabolic Syndrome; Psoriasis