Urban-rural differences in catastrophic health expenditure among households with chronic non-communicable disease patients: evidence from China family panel studies.
Urban-rural differences in catastrophic health expenditure among households with chronic non-communicable disease patients: evidence from China family panel studies.
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DOI：
10.1186/s12889-021-10887-6
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发表时间：
2021-05-06
影响因子：
4.5
通讯作者：
He JJ
中科院分区：
文献类型：
--
作者：
Fu XZ;Sun QW;Sun CQ;Xu F;He JJ
慢性非传染性疾病的流行给中国卫生体制改革提出了挑战。很少有人知道的差异，灾难性的卫生支出（CHE）之间的城市和农村家庭的非传染性疾病患者。本研究旨在测量上述差异，并量化每个变量在解释城乡差异中的贡献。不平衡的面板数据来自2012年至2018年进行的中国家庭面板研究（CFPS）。运用费尔利非线性分解和Blinder-Oaxaca分解技术，测算各自变量对城乡差异的贡献。NCD患者家庭的CHE发病率和强度在农村地区明显高于城市地区。CHE发病率城乡差异从2012年的8.07%上升到2018年的8.18%，CHE强度城乡差异从2012年的2.15%下降到2018年的2.05%。从2012年到2018年，由家庭收入和户主自评健康状况解释的差距有所增加。同一时期，受教育程度对CHE发病率城乡差异的贡献有所下降，而对CHE强度城乡差异的贡献略有上升。与城市非传染性疾病患者家庭相比，农村非传染性疾病患者家庭发生CHE的风险更高，疾病经济负担更重。与2012年相比，2018年CHE发生率和强度的城乡不平等没有实质性变化。政策干预应优先考虑提高农村非传染性疾病患者的家庭收入、教育程度和健康意识。在线版本包含补充材料，可通过10.1186/s12889-021-10887-6获得。
The prevalence of chronic non-communicable diseases (NCDs) challenges the Chinese health system reform. Little is known for the differences in catastrophic health expenditure (CHE) between urban and rural households with NCD patients. This study aims to measure the differences above and quantify the contribution of each variable in explaining the urban-rural differences. Unbalanced panel data were obtained from the China Family Panel Studies (CFPS) conducted between 2012 and 2018. The techniques of Fairlie nonlinear decomposition and Blinder-Oaxaca decomposition were employed to measure the contribution of each independent variable to the urban-rural differences. The CHE incidence and intensity of households with NCD patients were significantly higher in rural areas than in urban areas. The urban-rural differences in CHE incidence increased from 8.07% in 2012 to 8.18% in 2018, while the urban-rural differences in CHE intensity decreased from 2.15% in 2012 to 2.05% in 2018. From 2012 to 2018, the disparity explained by household income and self-assessed health status of household head increased to some extent. During the same period, the contribution of education attainment to the urban-rural differences in CHE incidence decreased, while the contribution of education attainment to the urban-rural differences in CHE intensity increased slightly. Compared with urban households with NCD patients, rural households with NCD patients had higher risk of incurring CHE and heavier economic burden of diseases. There was no substantial change in urban-rural inequality in the incidence and intensity of CHE in 2018 compared to 2012. Policy interventions should give priority to improving the household income, education attainment and health awareness of rural patients with NCDs. The online version contains supplementary material available at 10.1186/s12889-021-10887-6.
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2.7
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