The Divergence of Inequality in Healthcare Utilization Between Poor- and Rich-Medical Resource Regions: Evidence from the Middle-Aged and Older Adults in China

Fang, Ya’nan; Fu, Liping; Xu, Yanqing; Dong, Yongqing

doi:10.1007/s11205-023-03286-4

Cited by 1 publication

(3 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compared with the results of previous studies, the concentration index of outpatient service utilization obtained in this study tends to 0, and the concentration index of inpatient service utilization is smaller than that of previous studies, indicating that the degree of inequality has been improved, which is also the achievement of China's new medical reform in promoting the fairness of residents' health service utilization.A previous study had the same results [24].…”

Section: Discussionsupporting

confidence: 71%

“…Gansu Province, located in the upper reaches of the Yellow River in Northwest China, is an economically underdeveloped region in China. By the end of 2022, the province's permanent resident population was 24,924,200, with a per capita disposable income of 37,572 yuan for urban residents and 12,165 yuan for rural residents, both of which are signi cantly lower than the national average (48,282.9 yuan for urban residents and 20,132.9 yuan for rural residents) [22]. In 2021, the number of health institutions in the province was 25,759, and the number of health technicians per 1,000 people was 8.07, which is signi cantly lower than that in the central and western regions.…”

mentioning

confidence: 99%

“…Previous studies have focused on equity analysis of health service utilization in different subgroups (social vulnerable groups) [24][25][26][27], but there were few studies on the equity of health services of the whole population. Based on the latest data from the 7th National Health Service Survey in Gansu Province in 2023, this study used Gansu Province in 2023 as an example to study the health service utilization of residents in less developed areas of China and further explored the fairness of health service utilization level (personal health expenditure) on the basis of the fairness of health service utilization.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Health services Equity in less developed areas of China: Evidence from Gansu Province

Zhou,

Li,

Mao

et al. 2024

Preprint

View full text Add to dashboard Cite

Background Equity is a key issue in the utilization of health services. All countries in the world are constantly exploring the reform of health system to promote the equality of residents' utilization of health services. Methods Using the data of the 7th National Health Service Survey of Gansu Province in 2023 as an example, based on the Anderson model, the equity of health services utilization and its influencing factors were evaluated by using the concentration index(CI) and its decomposition method. On this basis, we screened patients who had used outpatient or inpatient services from the survey subjects and extracted their out-of-pocket(oop) expenditures incurred by using the above services. RIF regression and its decomposition method based on counterfactual analysis were used to analyze the differences in the equity of health service utilization level between urban and rural residents, and the contributing factors were discussed. Results The concentration index of outpatient service utilization (two-week visit rate) of urban and rural residents were 0.0422 and -0.0268, and the concentration index of inpatient service utilization (hospitalization rate) were 0.1462 and -0.1294, respectively. Both outpatient and inpatient services tend to be utilized by high-income residents in cities, while in rural areas, the lower the economic level of residents, the higher the utilization rate. Further analysis of the level of health service utilization showed that the Gini coefficients of out-of-pocket expenditures for urban and rural patients were 0.703 and 0.748, respectively, indicating high inequality. RIF regression and its decomposition results show that rural patients have greater inequality than urban patients in outpatient and inpatient out-of-pocket expenditures, and there is discrimination effect. Conclusion At present, there are still inequities in the utilization of health services in less developed areas of China, especially in the utilization of hospitalization services, but the degree of inequity is lower than that in previous studies. In terms of the fairness of health service utilization level, the inequality of degree of rural residents is greater than that of urban residents, and there is a greater discrimination effect.

show abstract

Section: Discussionsupporting

confidence: 71%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation