Socioeconomic inequity in inpatient service utilization based on need among internal migrants: evidence from 2014 national cross-sectional survey in China.
Socioeconomic inequity in inpatient service utilization based on need among internal migrants: evidence from 2014 national cross-sectional survey in China.
复制标题
基于内部移民的需求，住院服务利用的社会经济不平等：2014年中国国家横断面调查的证据。
DOI：
10.1186/s12913-020-05843-w
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发表时间：
2020-10-27
影响因子：
2.8
通讯作者：
Zhou C
中科院分区：
文献类型：
--
作者：
Wang Y;Jing Z;Ding L;Tang X;Feng Y;Li J;Chen Z;Zhou C
无论其社会经济和文化背景如何，为具有相同医疗保健需求的人提供平等待遇，已成为努力改善医疗保健的政策制定者的共同目标。本研究旨在通过一项具有全国代表性的研究，确定流动人口基于住院服务需求的社会经济地位（SES）不平等。本研究使用的数据来源于中国国家卫生健康委员会收集的2014年全国流动人口动态监测调查。本研究的抽样框架采用分层多阶段随机抽样方法。对所有省级城市带和重点城市进行分层，最终确定119层。我们采用logistic回归方法和Blinder-Oaxaca分解计算浓度指数，以需求为基础衡量SES在住院服务利用中的不公平性。所有分析均采用调查中提供的样本权重，本研究中所有标准误差均在地层水平上聚类。在所有内部流动人口中，18.75%的住院服务需求得不到满足。结果表明，住院服务利用集中在高SES流动人口中（浓度指数：0.036,p < 0.001），分解结果表明，住院服务利用的总SES差距约44.16%可归因于梯度效应。在调整其他混杂变量后，高中学历和大学学历的患者更有可能满足住院服务需求，OR值分别为1.48 （95% CI 1.07, 2.03, p = 0.017）和2.04 （95% CI 1.45, 2.88, p = 0.001）。第三和第四分位数收入组的OR值分别为1.28 （95% CI 1.01, 1.62, p = 0.044）和1.37 （95% CI 1.02, 1.83, p = 0.035）。本研究观察到住院服务利用的不平等，其中利用集中在高SES移民。重要的是决策者要意识到这一点，并应进行更多的干预。本文附有补充信息：10.1186/s12913-020-05843-w。
Providing equal treatment for those who have the same need for healthcare, regardless of their socioeconomic and cultural background, has become a shared goal among policymakers who strive to improve healthcare. This study aims to identify the socioeconomic status (SES) inequities in inpatient service utilization based on need among migrants by using a nationally representative study in China. The data used in this study was derived from the 2014 National Internal Migrant Population Dynamic Monitoring Survey collected by the National Health Commission of China. The sampling frame for this study was taken using the stratified multistage random sampling method. All provincial urban belt and key cities were stratified, and 119 strata were finally determined. We used logistic regression method and Blinder-Oaxaca decomposition and calculated the concentration index to measure inequities of SES in inpatient service utilization based on need. Sample weights provided in the survey were applied in all the analysis and all standard errors in this study were clustered at the strata level. Of the total internal migrants, 18.75% unmet the inpatient service need. Results showed that inpatient service utilization concentrated among high-SES migrants (Concentration Index: 0.036, p < 0.001) and the decomposition results suggested that about 44.16% of the total SES gap in inpatient service utilization could be attributed to the gradient effect. After adjusting for other confounding variables, those had high school degree and university degree were more likely to meet the inpatient services need, and the OR values were 1.48 (95% CI 1.07, 2.03, p = 0.017) and 2.04 (95% CI 1.45, 2.88, p = 0.001), respectively. The OR values for Quartile 3 and Quartile 4 income groups was 1.28 (95% CI 1.01, 1.62, p = 0.044) and 1.37 (95% CI 1.02, 1.83, p = 0.035), respectively. This study observed an inequity in inpatient service utilization where the utilization concentrates among high SES migrants. It is important for policy makers to be aware of them and more intervention should be conducted. Supplementary information accompanies this paper at 10.1186/s12913-020-05843-w.
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影响因子：
3.2
作者：
Elwell-Sutton, Timothy M.;Jiang, Chao Qiang;Schooling, C. M.
通讯作者：
Schooling, C. M.
影响因子：
3.2
作者：
An, Fansuo;Broadbent, Kaye;Yuan, Fang
通讯作者：
Yuan, Fang
影响因子：
4.5
作者：
Zeng J;Zou G;Song X;Ling L
通讯作者：
Ling L
DOI：
10.3390/ijerph120202205
发表时间：
2015-02-16
影响因子：
--
作者：
Lu CH;Luo ZC;Wang JJ;Zhong JH;Wang PX
通讯作者：
Wang PX
影响因子：
3.3
作者：
Kelishadi, Roya;Qorbani, Mostafa;Mansourian, Morteza
通讯作者：
Mansourian, Morteza