Determinants of health care demand in poor, rural China: the case of Gansu Province
Determinants of health care demand in poor, rural China: the case of Gansu Province
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DOI：
10.1093/heapol/czp016
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发表时间：
2009-09-01
影响因子：
3.2
通讯作者：
Meng, Qingyue
中科院分区：
文献类型：
--
作者：
Qian, Dongfu;Pong, Raymond W.;Meng, Qingyue
中国，本文考察了影响甘肃省农村地区卫生保健需求决策的决定因素。这是中国首次对护理价格对提供者选择的影响进行识别和量化，也是中国首次以农村贫困地区为研究对象对这一主题进行量化考察。在中国的农村三级医疗保障体系中，我们使用混合多项Logit模型进一步区分了村公办卫生室和私立村卫生室。结果表明，价格和距离对医疗服务提供者的选择有显著影响。低收入群体的门诊需求价格弹性高于高收入群体。当门诊患者对提供者的质量或声誉有特别的担忧时，或者当他们的健康状况不佳时，距离往往不那么重要，即他们愿意走得更远，以获得更好的疾病治疗。参保状况对村公办卫生室相对于自我治疗的选择有显著影响。此外，年龄和疾病属性也是统计上有意义的因素。我们讨论了研究结果对满足中国农村贫困人口医疗保健需求的政策含义。
This paper examines the determinants that influence health care demand decisions in rural areas of Gansu province, China. This represents the first effort to identify and quantify the effect of price of care on choice of provider in China, and is the first quantitative examination of this topic focusing on poor rural areas in China. In the three-tier health care system in rural China, we further distinguish the public village clinics and private village clinics using a mixed multinomial logit model. The results show that price and distance play significant roles in choice of health care provider. The price elasticity of demand for outpatients is higher for low-income groups than for high-income groups. When outpatients have particular concerns about provider quality or reputation, or when their health status is poor, distance tends to matter less, i.e. they are willing to travel further in order to obtain better treatment for their illness. Insurance status has a significant impact on the choice of public village clinics relative to self-treatment. Furthermore, age and the attributes of illness are also statistically significant factors. We discuss the policy implications of the results for meeting the health care needs of the poor in rural China.