Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage

Abstract

Worldwide countries are recognising the need for and significance of universal health coverage (UHC); however, health inequality continues to persist. This study evaluates the status and equity of residents’ demand for and utilisation of health services and expenditure by considering the three components of universal health coverage, urban-rural differences, and different income groups. Sample data from China’s Fifth Health Service Survey were analysed and the ‘five levels of income classification’ were used to classify people into income groups. This study used descriptive analysis and concentration index and concentration curve for equity evaluation. Statistically significant differences were found in the demand and utilisation of health services between urban and rural residents. Rural residents’ demand and utilisation of health services decreased with an increase in income and their health expenditure was higher than that of urban residents. Compared with middle- and high-income rural residents, middle- and lower-income rural residents faced higher hospitalisation expenses; and, compared with urban residents, equity in rural residents’ demand and utilisation of health services, and annual health and hospitalisation expenditures, were poorer. Thus, equity of health service utilisation and expenditure for urban and rural residents with different incomes remain problematic, requiring improved access and health policies.

Self-Rated Health Status Based on the Type of Health Insurance: A Socioeconomic Perspective

“…This is consistent with the previous studies that suggested health inequality is a plausible explanation for the link between SES and health outcomes. 18 Previous research has also shown that the NHI system in a country has created a health gap based on income gaps, but according to the results of this study, 9 health status was significantly poor for the group alienated from the NHI and had a low educational level. It is estimated that the interaction effect for household income was not significant because eligibility for MA recipients in Korea is based on an individual’s income.…”

“… 8 In the case of China also, compared to high-income groups, lower-income groups faced higher hospitalization expenses under the universal health service, and health inequality continues to persist. 9 Therefore, it is questionable whether Korea’s NHI system is effective in reducing health disparities.…”

Influencing factors of multiple adverse outcomes among schizophrenia patients using count regression models: a cross-sectional study

“…Similarly, poverty was an individual protective factor for aggressiveness with police dispatch or violent crime. This may be attributed to the higher rate of receiving regular follow-ups and increasing demand and utilization of health services among patients under the poverty lines [51,54].…”

Influencing Factors of Multiple Adverse Outcomes Among Schizophrenia Patients Using Count Regression Models: A Cross-Sectional Study

“…Similarly, poverty was an individual protective factor for aggressiveness with police dispatch or violent crime. This may be attributed to the higher rate of receiving follow-ups regularly and increasing demand and utilization of health services among poverty patients [49,52].…”