Inequality of opportunity in health service utilization among middle-aged and elderly community-dwelling adults in China

Zhu, Lin; Peng, Mingyao; Jiang, Luyan; Wang, Zhonghua

doi:10.1186/s13690-022-01010-1

Cited by 7 publications

(6 citation statements)

References 58 publications

(87 reference statements)

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“…Improving equality of health service utilization is the basis for realizing health equity [ 48 ]. Moreover, justice and equity are one of critical principles in Healthy China 2030 [ 49 ]. The utilization of health services may interplay between various factors.…”

Section: Discussionmentioning

confidence: 99%

Determinants of province-based health service utilization according to Andersen’ s Behavioral Model: a population-based spatial panel modeling study

Ren

2023

BMC Public Health

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Objective The Andersen’ s Behavioral Model was used to explore the impact of various factors on the utilization of health services. The purpose of this study is to establish a provincial-level proxy framework for the utilization of health services from a spatial perspective, based on the influencing factors of the Andersen’ s Behavioral Model. Method Provincial-level health service utilization was estimated by the annual hospitalization rate of residents and the average number of outpatient visits per year from China Statistical Yearbook 2010–2021. Exploring the relevant influencing factors of health service utilization using the spatial panel Durbin model. Spatial spillover effects were introduced to interpret the direct and indirect effects influenced by the proxy framework for predisposing, enabling, and need factors on health services utilization. Results From 2010 − 2020, the resident hospitalization rate increased from 6.39% ± 1.23% to 15.57% ± 2.61%, and the average number of outpatient visits per year increased from 1.53 ± 0.86 to 5.30 ± 1.54 in China. For different provinces, the utilization of health services is uneven. The results of the Durbin model show that locally influencing factors were statistically significantly related to an increase in the resident hospitalization rate, including the proportion of 65-year-olds, GDP per capita, percentage of medical insurance participants, and health resources index, while statistically related to the average number of outpatient visits per year, including the illiteracy rate and GDP per capita. Direct and indirect effects decomposition of resident hospitalization rate associated influencing factors demonstrated that proportion of 65-year-olds, GDP per capita, percentage of medical insurance participants, and health resources index not only affected local resident hospitalization rate but also exerted spatial spillover effects toward geographical neighbors. The illiteracy rate and GDP per capita have significant local and neighbor impacts on the average number of outpatient visits. Conclusion Health services utilization was a variable varied by region and should be considered in a geographic context with spatial attributes. From the spatial perspective, this study identified the local and neighbor impacts of predisposing factors, enabling factors, and need factors that contributed to disparities in local health services utilization.

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Section: Discussionmentioning

confidence: 99%

Determinants of province-based health service utilization according to Andersen’ s Behavioral Model: a population-based spatial panel modeling study

Ren

2023

BMC Public Health

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“…This study validates the internet compensation theory that internet use plays an important role in improving mental health outcomes. Middle-aged and older adults, especially those with functional disability, face barriers to accessing health services and participating fully in society ( 52 ). For this group, the internet, as an emerging technology, can provide health care, entertainment, shopping information, etc., and enhance social connections.…”

Section: Discussionmentioning

confidence: 99%

The effect of internet use on depressive symptoms in middle-aged and older adults with functional disability: the mediating role of social isolation

Zhao

et al. 2023

Front. Public Health

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ObjectiveThe popularization of the internet provides the possibility to improve the depressive symptoms (DS) and social isolation of middle-aged and older adults with functional disability. There was a significant correlation between internet use and DS in middle-aged and older adults with functional disability, but the relationship between internet use, social isolation, and DS remains to be confirmed.MethodsData were obtained from 7,955 middle-aged and older adults aged 45 years and older from the 2018 China Health and Retirement Longitudinal Study (CHARLS). Multiple linear regression models were used to analyze the association between internet use and DS, and the Sobel test was used to explore mediating models.ResultsResults showed that internet use was negatively associated with DS among Chinese middle-aged and older adults. Among them, social needs (B = −0.770, p = 0.041), and information reception (B = −1.067, p = 0.007) were significantly related to DS in middle-aged and older adults. Only information reception (B = −3.161, p = 0.031) was significantly related to DS among middle-aged and older adults with functional disability. Social isolation partially mediated the association between internet use and DS in middle-aged and older adults without functional disability, whereas it was fully mediated in middle-aged and older adults with functional disability.ConclusionThis study indicates that when formulating health policies to promote the mental health of Chinese middle-aged and older adults, the use of the internet should not be overlooked.

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“…Horizontal equity is achieved when individuals with similar needs have equal access to and utilization of healthcare. Vertical equity means those with greater health needs should receive more care than those with fewer needs (12). Therefore, examining justice and inequality in health resource distribution is pivotal for policymaking and resource allocation, including physicians, beds, and equipment (13,14).…”

Section: Introductionmentioning

confidence: 99%

Investigating the Inequality Trend in Health Resource Distribution in Iran: A Case Study in Bushehr Province

Rezaee,

Azmal,

Lotfi

et al. 2024

Shiraz E-Med J

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Background: Equity in access to health resources is a fundamental goal of health systems worldwide. Objectives: This study aims to assess the distribution of essential health resources necessary for healthcare provision in Bushehr Province. Methods: This cross-sectional study spans ten years and utilizes several widely recognized indices in health resource distribution equity and equality, including the Gini Coefficient, Concentration Index, Horizontal Inequity, Robin Hood Index, Theil Index, Atkinson Index, and Quantile Ratio. These indices were calculated based on both the population level and the proposed resource allocation model (PRAM) using Excel Software 2018 and Stata version 18. Results: The findings indicate a degree of inequality in the distribution of all health resources examined, with special beds exhibiting much higher levels of inequality than others. The sensitivity of the studied indices varied across the distributed resources. Moreover, the trend of inequality generally decreased for all examined resources. The PRAM results suggest that adopting a different approach to resource distribution can significantly reduce inequality levels. Conclusions: Despite a downward trend in the inequality of health resource distribution, significant disparities persist. Altering the resource distribution system from the conventional geographical division could aid in achieving equity and equality in healthcare. Such changes could also reduce the costs associated with the health system.

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Inequality of opportunity in health service utilization among middle-aged and elderly community-dwelling adults in China

Cited by 7 publications

References 58 publications

Determinants of province-based health service utilization according to Andersen’ s Behavioral Model: a population-based spatial panel modeling study

Determinants of province-based health service utilization according to Andersen’ s Behavioral Model: a population-based spatial panel modeling study

The effect of internet use on depressive symptoms in middle-aged and older adults with functional disability: the mediating role of social isolation

Investigating the Inequality Trend in Health Resource Distribution in Iran: A Case Study in Bushehr Province

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