Rural-urban disparities in unmet long-term care needs in China: The role of the hukou status

Zhu, Yumei; Österle, August

doi:10.1016/j.socscimed.2017.08.025

Cited by 98 publications

(94 citation statements)

References 40 publications

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“…Consistent with previous studies, we also found that women with urban Hukou were more likely to provide informal care than those with rural Hukou [35,36]. There were several potential explanations for the urban-rural disparity observed in this study.…”

Section: Ses Variables (See Appendixsupporting

confidence: 91%

The effect of socioeconomic status on informal caregiving intensity of adult females for parents: Evidence from a national study in China

Wang¹,

Li²,

Ding³

et al. 2020

Preprint

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Background Few studies explored the effect of SES of caregivers on informal caregiving in China, especially from a female perspective. The purpose of this study was to empirically examine how the SES of female caregivers affects the amount of informal care they provide for parents in China. Methods The data used in this study was derived from the China Health and Nutrition Survey (CHNS). Informal caregivers were divided into three categories: non-caregivers (0 hrs/week), low-intensity caregivers (less than 10 hrs/week), and high-intensity caregivers (more than 10 hrs/week). Chi-square tests and one-way analysis of variance (ANOVA) were used to compare the SES of the women between non-, low-, and high-intensity caregivers. Multinomial logistic regression analysis was used to calculate relative risk ratios (RRR) for various SES variables to assess the relation of SES on the likelihood of a low- and high-intensity caregiving in the household, adjusting for age, marital status, family characteristics and wave. Results Of the 2741 respondents, high-intensity and low-intensity caregivers accounted for 16.42% and 21.38% respectively. Multinomial logistic regression results found that the likelihood of being a high-intensity caregiver vs. a non-caregivers increased as the caregiver’s education attainment increased. Urban females were 1.34 times more likely than their rural counterparts to provide low-intensity care vs. no care ( p <0.05) and were 1.34 times more likely to provide high-intensity care vs. no care ( p <0.05). Employed females were 1.27 times more likely than those non-employed to provide low-intensity care vs. no care ( p <0.05). Conclusions Differences in SES were found between high-intensity caregivers and low-intensity caregivers. Women with higher SES (higher education attainment, higher incomes, and urban Hukou ) were more likely to provide high-intensity informal care, and women who were employed and with urban Hukou were more likely to provide low-intensity care.

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Section: Ses Variables (See Appendixsupporting

confidence: 91%

The effect of socioeconomic status on informal caregiving intensity of adult females for parents: Evidence from a national study in China

Wang¹,

Li²,

Ding³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Evidence from previous studies indicates that China's rural–urban disparities in income and in access to medical care result in differences in health outcomes, with the rural population being worse off than the urban counterpart . An analysis of data from CHARLS also showed that rural–urban disparities exist in unmet LTC needs and that the gap increased significantly with the intensity of needs . The majority of people with potentially greater LTC needs are those in the rural population, but the exclusion under most LTCI pilots leaves them lacking access to LTC.…”

Section: Discussionmentioning

confidence: 98%

“…Hence, the need for LTC coverage outside traditional informal networks and the risk for unmet LTC needs will grow substantially in China . Additionally, China also faces challenges to bridge disparities in LTC needs and LTC coverage among different socioeconomic groups and regions during its rapid socioeconomic modernization and urbanization . In this context, the Chinese government has started a process of policy experimentation for long‐term care insurance (LTCI) in 2016, aiming at establishing and improving the policy framework for social LTCI till 2020.…”

Section: Introductionmentioning

confidence: 99%

China's policy experimentation on long‐term care insurance: Implications for access

Zhu

Österle

2019

Health Planning & Management

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Summary China's population is aging rapidly, while the traditional long‐term care (LTC) system that heavily relies on families is eroding. In response, China has embarked on a journey of policy experimentation for long‐term care insurance (LTCI) since 2016, launching LTCI pilots in 15 pioneer cities. These pilots have a great diversity in participation, eligibility, and provision. This paper estimates the prevalence of LTC needs and analyzes the impact of the LTCI pilots on access. Although substantial progress has been achieved, the overall coverage of LTCI is still relatively small, and a large proportion of vulnerable people needing LTC seem to be left behind because of the strict eligibility criteria. This analysis suggests that future policy experimentation on LTCI reform in China needs to address the following pressing policy issues: expanding the coverage of LTCI; narrowing rural–urban disparities in access; improving access for vulnerable subpopulations; and reducing the heavy reliance on institutional care.

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“…Another factor worth exploring is the influence of the household registration system. In China, this system has proven to be more strongly linked to unmet long-term care needs than the place of residence (52 The two main metropolitan areas in the country benefit from a concentration of highly equipped healthcare facilities in densely populated zones served by viable transport and road networks (28). This situation leads to a high number of deliveries within specialized healthcare services, as exemplified by the National Hospital of Gynaecology and Obstetrics in Hanoi, where more than 20,000 deliveries take place annually, with a CS rate of 48% 1 .…”

Section: Discussionmentioning

confidence: 99%

Magnitude and Correlates of Caesarean Section in Urban and Rural Areas: A Multivariate Study in Vietnam

Loenzien

Schantz

Luu

et al. 2019

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Caesarean section can prevent maternal and neonatal mortality and morbidity. However, it involves risks and high costs which can be a burden, especially in low and middle income countries. The international healthcare community considers the optimal caesarean rate to be between 10% and 15%. The aim of this study is to assess its magnitude and correlates among women of reproductive age in urban and rural areas in Vietnam. We analyzed microdata from the national Multiple Indicator Cluster Survey (MICS) conducted in 2013-2014 using representative sample of households at the national level as well as regarding the urban and the rural areas. A total of 1,378 women who delivered in institutional settings in the two years preceding the survey were included. Frequency and percentage distributions of the variables were performed. Bivariate and multivariate logistic regression analysis were undertaken to identify the factors associated with caesarean section. Odds ratios with 95% confidence interval were used to ascertain the direction and strength of the associations. The overall CS rate among the women who delivered in healthcare facilities in Vietnam is particularly high (29.2%) with regards to WHO standards. After controlling for significant characteristics, living in urban areas more than doubles the likelihood of undergoing a CS (OR = 2.31; 95% CI 1.79 to 2.98). Maternal age at delivery over 35 is a major positive correlate of CS. Beyond this common phenomenon, distinct lines of socioeconomic and demographic cleavage operate in urban versus rural areas. The differences regarding correlates of CS according to the place of residence suggest that specific measures should be taken in each setting to allow women to access childbirth services appropriate to their needs. Further research is needed on this topic.

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Rural-urban disparities in unmet long-term care needs in China: The role of the hukou status

Cited by 98 publications

References 40 publications

The effect of socioeconomic status on informal caregiving intensity of adult females for parents: Evidence from a national study in China

The effect of socioeconomic status on informal caregiving intensity of adult females for parents: Evidence from a national study in China

China's policy experimentation on long‐term care insurance: Implications for access

Magnitude and Correlates of Caesarean Section in Urban and Rural Areas: A Multivariate Study in Vietnam

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