Effect of China’s maternal health policy on improving rural hospital delivery: Evidence from two cross-sectional surveys

Fan, Xiaojing; Xu, Yu; Stewart, Martyn; Zhou, Zhongliang; Dang, Shaonong; Wang, Duolao; Gao, Jianmin

doi:10.1038/s41598-018-29830-8

Cited by 9 publications

(7 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The CI value is between − 1 and 1. A positive CI indicates that health is more concentrated among members with higher per capita household income; by contrast, 0 indicates that there is no inequality [ 43 ]. The concentration index was computed with Eq.…”

Section: Methodsmentioning

confidence: 99%

“…The horizontal inequity (HI) of HRQOL indicates the inequality in HRQOL by eliminating the contribution of need variables. In the present investigation, the horizontal inequity index was generated by subtracting the contribution of the need variables (e.g., gender and age) from the concentration index of HRQOL [ 43 ]. The HI is positive if there exists a pro-rich inequity and vice versa.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of inequity in health-related quality of life among unemployed and employed individuals in China

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background In China, achieving health equity has been regarded as a key issue for health reform and development in the current context. It is well known that unemployment has a negative effect on health. However, few studies have addressed the association between unemployment and inequity in health-related quality of life (HRQOL). This study aims to compare the inequality and inequity in HRQOL between the unemployed and employed in China. Methods The material regarding this study was derived from the Chinese National Health Services Survey of Shaanxi Province for 2013. We controlled for confounding factors by utilizing the coarsened exact matching method. Finally, 7524 employed individuals and 283 unemployed individuals who were 15 to 64 years old in urban areas were included in this study. We used HRQOL as the outcome variable, which was evaluated by using the Chinese version of EQ-5D-3L. The health concentration index, decomposition analysis based on the Tobit model, and the horizontal inequity index were employed to compute the socioeconomic-related equity between the unemployed and employed and the contribution of various factors. Results After matching, unemployed people tended to have poorer EQ-5D utility scores than employed people. There were statistically pro-rich inequalities in HRQOL among both employed and unemployed people, and the pro-rich health inequity of unemployed people was substantially higher than that of employed people. Economic status, age, education, smoking and health insurance were the factors influencing inequality in HRQOL between employed and unemployed individuals. Education status and basic health insurance have reduced the pro-rich inequity in HRQOL for unemployed people. Conclusion It is suggested that unemployment intensifies inequality and inequity in HRQOL. According to policymakers, basic health insurance is still a critical health policy for improving health equity for the unemployed. Intervention initiatives aiming to tackle long-term unemployment through active labour market programmes, narrow economic gaps, improve educational equity and promote the health status of the unemployed should be considered by the government to achieve health equity.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Comparison of inequity in health-related quality of life among unemployed and employed individuals in China

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…gender and age) from the concentration index of HRQOL [39] . The HI is positive that signifies that there exist a pro-rich inequity and vice versa.…”

Section: Horizontal Inequity Indexmentioning

confidence: 99%

Comparison of inequity in health-related quality of life among unemployed and employed in China

Zhao¹,

Zhou²,

Fan³

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background In China, achieving the health equity has been regarded as a key issue of health reforms and development in the current stage. It is well known that unemployment have a negative effect on health. However, few studies have addressed the association between unemployment and the inequity of health-related quality of life (HRQOL). The study aims to compare the inequality and inequity in HRQOL among the unemployed and employed in China. Methods The material regarding this study has been illustrated from the Chinese National Health Services Survey (NHSS) of Shaanxi Province for 2013. We have controlled the confounding factors by the utilization of coarsened exact matching method (CEM). Finally, 7,524 employed individuals and 283 unemployed individuals were aged 15 to 64 in urban area has been incorporated for this study. We use HRQOL as the outcome variable, which was evaluated by the Chinese version of EQ-5D-3L. Health concentration index, decomposition analysis based on the Tobit model and the horizontal inequity index were employed to compute the income-related equity and the contribution of factors among the unemployed and employed. Results After matching, unemployed people tended to express poorer EQ-5D utility than employed people. The horizontal inequity indices among employed and unemployed people were 0.0020 and 0.0077 respectively, demonstrating that the pro-rich health inequity of unemployed people was a great deal superior to employed people. Economic status, age, education, smoking and health insurances are the main impact factors that affect the inequality in HRQOL among employed and unemployed. Education status and basic health insurances reduce the pro-rich inequity in HRQOL for the unemployed. Conclusion It is suggested that unemployment intensifies the inequality and inequity in HRQOL. In view of the policy makers, the basic health insurances are still a critical health policy for improving health equity of the unemployed. Re-employment programs, the socialization of medical health insurances, initiatives to improve educational equity and the psychological counseling for the unemployed should be considered by government to attain health equity.

show abstract

“…The main causes of maternal death include obstetric hemorrhage, puerperal infection, amniotic fluid embolism, pregnancy-induced hypertension, liver disease, and heart disease, which are mostly preventable [ 15 ]. Hospital delivery means that pregnant women give birth in hospital, which is an effective strategy to prevent maternal and infant deaths [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Maternal mortality ratio in China from 1990 to 2019: trends, causes and correlations

et al. 2021

View full text Add to dashboard Cite

Background Maternal mortality ratio is an important indicator to evaluate the health status in developing countries. Previous studies on maternal mortality ratio in China were limited to certain areas or short periods of time, and there was a lack of research on correlations with public health funding. This study aimed to assess the trends in the maternal mortality ratio, the causes of maternal death, and the correlations between maternal mortality ratio and total health financing composition in China from 1990 to 2019. Methods Data in this longitudinal study were collected from the China Health Statistics Yearbooks (1991–2020) and China Statistical Yearbook 2020. Linear regression analysis was used to assess the trends in the maternal mortality ratio in China. Pearson correlation analysis was used to assess the correlations between national maternal mortality ratio and total health financing composition. Results The yearly trends of the national, rural and urban maternal mortality ratio were − 2.290 (p < 0.01), − 3.167 (p < 0.01), and − 0.901 (p < 0.01), respectively. The gap in maternal mortality ratio between urban and rural areas has narrowed. Obstetric hemorrhage was the leading cause of maternal death. The mortalities ratios for the main causes of maternal death all decreased in China from 1990 to 2019. The hospital delivery rate in China increased, with almost all pregnant women giving birth in hospitals in 2019. Government health expenditure as a proportion of total health expenditure was negatively correlated with the maternal mortality ratio (r = − 0.667, p < 0.01), and out-of-pocket health expenditure as a proportion of total health expenditure was positively correlated with the maternal mortality ratio (r = 0.516, p < 0.01). Conclusion China has made remarkable progress in improving maternal survival, especially in rural areas. The maternal mortality ratio in China showed a downward trend over time. To further reduce the maternal mortality ratio, China should take effective measures to prevent obstetric hemorrhage, increase the quality of obstetric care, improve the efficiency and fairness of the government health funding, reduce income inequality, and strengthen the medical security system.

show abstract

Effect of China’s maternal health policy on improving rural hospital delivery: Evidence from two cross-sectional surveys

Cited by 9 publications

References 36 publications

Comparison of inequity in health-related quality of life among unemployed and employed individuals in China

Comparison of inequity in health-related quality of life among unemployed and employed individuals in China

Comparison of inequity in health-related quality of life among unemployed and employed in China

Maternal mortality ratio in China from 1990 to 2019: trends, causes and correlations

Contact Info

Product

Resources

About