Inequality of public health and its role in spatial accessibility to medical facilities in China

Yin, Chengliang; He, Qingsong; Liu, Yanfang; Chen, Weiqiang; Gao, Yuan

doi:10.1016/j.apgeog.2018.01.011

Cited by 166 publications

(126 citation statements)

References 33 publications

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“…At present, in the practice of hierarchical medical treatment and online appointments diagnosis in China, there are still some serious problems such as over-concentration of patients in high-grade medical institutions, long time of treatment, crowded environment, overwork of doctors, and lack of timely treatment due to long waiting time [58][59][60]. However, some low-grade medical institutions, such as community hospitals, have the problems of insufficient patients and waste of medical resources [61][62][63]. In view of this, this paper proposes the following policy recommendations:…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Impact of China’s Hierarchical Medical System and Online Appointment Diagnosis System on the Sustainable Development of Public Health: A Case Study of Shanghai

2019

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In the study of the sustainable development of public health in China, academic circles have little to do with the unique hierarchical medical system and online appointment diagnosis system in China's medical system. Therefore, based on the medical situation in Shanghai, China, in addition to the traditional dimension of medical expenses, this paper fully considers the impact of the current hierarchical medical policy, constructs a selection model for medical treatment behavior under the hierarchical medical system and online appointment diagnosis system, and carries out simulation analysis through the cellular automata grid dynamic model. This paper finds that the time-cost-oriented medical treatment behavior of Chinese patients will have different distribution under the current hierarchical medical system and online appointment diagnosis system. (1) When the medical treatment system neither allows online appointment nor referral, a large number of patients congregated in high-grade hospitals, with the most unreasonable distribution. (2) With the implementation of the system of allowing referral and online appointment, patients are gradually diverted to lower-grade hospitals or off-peak hours, and the distribution is relatively improved.(3) If the medical treatment system allows both referral and online appointment, the distribution of patients is the most reasonable. Therefore, China's current hierarchical medical system and online appointment diagnosis system will, to a considerable extent, become a policy tool that affects patients' choice of hospitals and an effective means to achieve the rational allocation of existing medical resources, which will play an important role in the sustainable development of public health in China.

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Section: Discussionmentioning

confidence: 99%

Analysis of the Impact of China’s Hierarchical Medical System and Online Appointment Diagnosis System on the Sustainable Development of Public Health: A Case Study of Shanghai

2019

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“…For example, Hare explored the accessibility of cardiovascular hospital facilities by considering the number of beds and residents at different critical distances from each other [22]. Yin used network analysis to calculate the average shortest distance between residential areas and hospital facilities, applying the Theil index to evaluate regional inequality [27]. Cheng used the two-step floating catchment area (2SFCA) method to analyze spatial differences and heterogeneity in the accessibility of administrative hospitals for those using self-driving and public means of transport [24].…”

Section: Introductionmentioning

confidence: 99%

Spatial Accessibility to Hospitals Based on Web Mapping API: An Empirical Study in Kaifeng, China

et al. 2019

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The accessibility of hospital facilities is of great importance not only for maintaining social stability, but also for protecting the basic human right to health care. Traditional accessibility research often lacks consideration of the dynamic changes in transport costs and does not reflect the actual travel time of urban residents, which is critical to time-sensitive hospital services. To avoid these defects, this study considered the city of Kaifeng, China, as an empirical case, and directly acquired travel time data for two travel modes to the hospital in different time periods through web mapping API (Application Program Interface). Further, based on travel time calculations, we compared five baseline indicators. For the last indicator, we used the optimal weighted accessibility model to measure hospital accessibility for each residential area. The study discovered significant differences in the frequency and spatial distribution of hospital accessibility using public transit and self-driving modes of transportation. In addition, there is an imbalance between accessibility travel times in the study area and the number of arrivals at hospitals. In particular, different modes of transportation and different travel periods also have a certain impact on accessibility of medical treatment. The research results shed new light on the accessibility of urban public facilities and provide a scientific basis with which local governments can optimize the spatial structure of hospital resources.

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“…Leukemia requires repeated hospitalizations for treatment. 41 Hence, in terms of health services and treatment habits, 42,43 FCs preferred more specialized medical institutions to obtain better treatment for their loved ones with pediatric leukemia. Repeated hospitalizations require families, especially those living in rural areas, to bear more non-medical costs such as transportation and accommodation, which may not be covered by medical insurance.…”

Section: Discussionmentioning

confidence: 99%

Catastrophic health expenditures of households living with pediatric leukemia in China

et al. 2020

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Background Leukemia can create a significant economic burden on the patients and their families. The objective of this study is to assess the medical expenditure and compensation of pediatric leukemia, and to explore the incidence and determinants of catastrophic health expenditure (CHE) among households with pediatric leukemia patients in China. Methods A cross‐sectional interview was conducted among households living with pediatric leukemia using a questionnaire in two tertiary hospitals. CHE was defined as out‐of‐pocket (OOP) payments that were greater than or equal to 40% of a household's capacity to pay (CTP). Chi‐square tests and logistic regression analysis were performed to identify the determinants of CHE. Results Among 242 households living with pediatric leukemia, the mean OOP payment for pediatric leukemia healthcare was $9860, which accounted for approximately 35.7% of the mean household's CTP. The overall incidence of CHE was 43.4% and showed a downward trend with the lowest income group at 69.0% to the highest income group at 16.1%. The logistic regression model found that medical insurance, frequency of hospital admissions, charity assistance, and income level were significant predictors of CHE. Conclusion The results revealed that pediatric leukemia had a significant catastrophic effect on families, especially those with lower economic status. The occurrence of CHE in households living with pediatric leukemia could be reduced by addressing income disparity. In addition, extending coverage and improving compensation from medical insurance could also alleviate CHE. Some other measures that can be implemented are to address the barriers of charity assistance for vulnerable groups.

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Inequality of public health and its role in spatial accessibility to medical facilities in China

Cited by 166 publications

References 33 publications

Analysis of the Impact of China’s Hierarchical Medical System and Online Appointment Diagnosis System on the Sustainable Development of Public Health: A Case Study of Shanghai

Analysis of the Impact of China’s Hierarchical Medical System and Online Appointment Diagnosis System on the Sustainable Development of Public Health: A Case Study of Shanghai

Spatial Accessibility to Hospitals Based on Web Mapping API: An Empirical Study in Kaifeng, China

Catastrophic health expenditures of households living with pediatric leukemia in China

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