Does the Universal Health Insurance Program Affect Urban‐Rural Differences in Health Service Utilization Among the Elderly? Evidence From a Longitudinal Study in Taiwan

Liao, Pei‐An; Chang, Hung‐Hao; Yang, Fang-An

doi:10.1111/j.1748-0361.2011.00363.x

Cited by 30 publications

(18 citation statements)

References 29 publications

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“…We evaluated the impacts of the policy on catastrophic health expenditure with DD methodology, which estimates the effect of the policy by comparing pre-post difference in the outcome of treatment group (composed of people affected by the policy) with that of control group (composed of people not affected by the policy) (Chen et al, 2007;Liao et al, 2012;G. G. Liu et al, 2002;Mott et al, 2010;Polsky et al, 2009).…”

Section: Empirical Methodsmentioning

confidence: 99%

Impact of the policy of expanding benefit coverage for cancer patients on catastrophic health expenditure across different income groups in South Korea

Kim

Kwon

2015

Social Science & Medicine

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Section: Empirical Methodsmentioning

confidence: 99%

Impact of the policy of expanding benefit coverage for cancer patients on catastrophic health expenditure across different income groups in South Korea

Kim

Kwon

2015

Social Science & Medicine

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“…[11,12] Due to the obvious gap between urban and rural in China, preventive care services may present more serious challenge for rural healthcare providers. However, the majority of researches about urban–rural disparity in healthcare have focused on access to and utilization of inpatient and outpatient medical care services, [13–15] and only several studies explored the inequality in utilization of preventive care services. Chen et al [16] and Yu [17] have noted that rural residents were less likely to utilize preventive care services than urban residents in China, and these studies also showed that age, income, education, health insurance, and chronic disease were associated with utilization of preventive care.…”

Section: Introductionmentioning

confidence: 99%

Urban–rural disparity in utilization of preventive care services in China

Liu

et al. 2016

Medicine

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Preventive care service is considered pivotal on the background of demographic ageing and a rise in chronic diseases in China. The disparity in utilization of preventive care services between urban and rural in China is a serious issue. In this paper, we explored factors associated with urban–rural disparity in utilization of preventive care services in China, and determined how much of the urban–rural disparity was attributable to each determinant of utilization in preventive care services. Using representative sample data from China Health and Nutrition Survey in 2011 (N = 12,976), the present study performed multilevel logistic model to examine the factors that affected utilization of preventive care services in last 4 weeks. Blinder–Oaxaca decomposition method was applied to divide the utilization of preventive care disparity between urban and rural residents into a part that can be explained by differences in observed covariates and unobserved part. The percentage of rural residents utilizing preventive care service in last 4 weeks was lower than that of urban residents (5.1% vs 9.3%). Female, the aged, residents with higher education level and household income, residents reporting self-perceived illness in last 4 weeks and physician-diagnosed chronic disease had higher likelihood of utilizing preventive care services. Household income was the most important factor accounting for 26.6% of urban–rural disparities in utilization of preventive care services, followed by education (21.5%), self-perceived illness in last 4 weeks (7.8%), hypertension (4.4%), diabetes (3.3%), other chronic diseases (0.8%), and health insurance (−1.0%). Efforts to reduce financial barriers for low-income individuals who cannot afford preventive services, increasing awareness of the importance of obtaining preventive health services and providing more preventive health services covered by health insurance, may help to reduce the gap of preventive care services utilization between urban and rural.

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“… 13 The elderly in rural areas utilised less health services than did their counterparts in urban areas in Taiwan. 14 There were also urban–rural differences in people's attitude towards modern medicine 15 and patients’ capability of affording psychiatric inpatient service. 16 Presumably, some aspects of urban–rural inequity, especially patients’ service availability and affordability, could be amended by a well-established UHC.…”

Section: Introductionmentioning

confidence: 99%

Impact of universal health coverage on urban–rural inequity in psychiatric service utilisation for patients with first admission for psychosis: a 10-year nationwide population-based study in Taiwan

et al. 2016

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Objective: To examine the disparities in psychiatric service utilisation over a 10-year period for patients with first admission for psychosis in relation to urbanrural residence following the implementation of universal health coverage in Taiwan.Design: Population-based retrospective cohort study. Setting: Taiwan Main outcome measures: Absolute and relative inequality indexes of the following quality indicators after discharge from the first admission: all-cause psychiatric readmission at 2 and 4 years, dropout of psychiatric outpatient service at 30 days, and emergency department (ED) treat-and-release encounter at 30 days.Results: Between 1998 and 2007, the 4-year readmission rate decreased from 65% to 58%, the 30-day dropout rate decreased from 18% to 15%, and the 30-day ED encounter rate increased from 8% to 10%. Risk of readmission has significantly decreased in rural and urban patients, but at a slower speed for the rural patients ( p=0.026). The adjusted HR of readmission in rural versus urban patients has increased from 1.00 (95% CI 0.96 to 1.04) in 1998-2000 to 1.08 (95% CI 1.03 to 1.12) in 2005-2007, indicating a mild widening of the urban-rural gap. Urban-rural differences in 30-day dropout and ED encounter rates have been stationary over time.

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Does the Universal Health Insurance Program Affect Urban‐Rural Differences in Health Service Utilization Among the Elderly? Evidence From a Longitudinal Study in Taiwan

Cited by 30 publications

References 29 publications

Impact of the policy of expanding benefit coverage for cancer patients on catastrophic health expenditure across different income groups in South Korea

Impact of the policy of expanding benefit coverage for cancer patients on catastrophic health expenditure across different income groups in South Korea

Urban–rural disparity in utilization of preventive care services in China

Impact of universal health coverage on urban–rural inequity in psychiatric service utilisation for patients with first admission for psychosis: a 10-year nationwide population-based study in Taiwan

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