Inequity in Health Services Utilization in Economically Underdeveloped Regions of Northeast China

Bibliographic Data

ID22076141
AuthorsXin Zhang (0000-0003-0184-5868, Harbin Medical University), Ning Ning (0000-0002-8297-1518, Harbin Medical University), Hongguo Zhou (Ningbo College of Health Sciences), Linghan Shan (0000-0001-6837-2968, Harbin Medical University), Yanhua Hao (0000-0002-0841-2291, Harbin Medical University), Mingli Jiao (0000-0002-2984-2928, Harbin Medical University), Libo Liang (0000-0002-4444-9497, Harbin Medical University), Zheng Kang (0000-0001-8913-7617, Harbin Medical University), Ye Li (0000-0002-5043-9797, Harbin Medical University), Huan Liu (0000-0001-8772-1545, Harbin Medical University), Baohua Liu (0000-0002-8065-9723, Ningbo College of Health Sciences), Kexin Wang (0009-0006-0995-438X, Harbin Medical University), Adelina Ruzieva (Harbin Medical University), Lijun Gao (0000-0001-6478-3305, Harbin Medical University, corresponding author), Qunhong Wu (0000-0002-2873-5266, Harbin Medical University, corresponding author)
Year2022
Volume10
Pages850157-850157
Publication date2022-04-15
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2022.850157
PMID35493377
OpenAlexW4224032045
LanguageEN
Citations received4
References cited42

Background: The Chinese health system has long been committed to eliminating inequalities in health services utilization. However, few studies have analyzed or measured these inequalities in economically underdeveloped regions in China. Methods: A total of 6,627 respondents from 3,000 households in Heilongjiang Province were extracted from the Sixth National Health Services Survey. We measured horizontal inequity in both 2-week outpatient rate and annual inpatient rate, and then identified the factors contributing to inequality. Results: The horizontal inequity indices of the 2-week outpatient and annual impatient rates in Heilongjiang Province were 0.0586 and 0.1276, respectively. Household income, health status, place of residence, basic medical insurance, and commercial health insurance were found to be the main factors affecting inequality in health services utilization. The contributions of household income to these two indices were 184.03 and 253.47%, respectively. Health status factors, including suffering from chronic disease, limitations in daily activities, and poor self-rated health, played positive roles in reducing inequality in these two indices. The contributions of place of residence to these two indices were 27.21 and -28.45%, respectively. Urban Employee Basic Medical Insurance made a pro-rich contribution to these two indices: 56.25 and 81.48%, respectively. Urban and Rural Resident Basic Medical Insurance, Urban Resident Basic Medical Insurance, New Rural Cooperative Medical Scheme, and other basic medical insurance made a pro-poor contribution to these two indices: -73.51 and -54.87%, respectively. Commercial health insurance made a pro-rich contribution to these two indices: 20.79 and 7.40%, respectively. Meanwhile, critical illness insurance made a slightly pro-poor contribution to these two indices: -4.60 and -0.90%, respectively. Conclusions: The findings showed that the "equal treatment in equal need" principle was not met in the health services utilization context in Heilongjiang Province. To address this issue, the government could make policy changes to protect low-income populations from underused health services, and work to improve basic medical insurance, critical illness insurance, and social security systems

Business · China · Developing country · Development economics · Economic growth · Economics · Environmental health · Geography · Health services · Population · Healthcare Policy and Management · Healthcare Systems and Reforms · Intergenerational Family Dynamics and Caregiving · Medicine

Tools

Open DOIOpen Access