Horizontal Inequity in Health Care Utilization among the Middle-Aged and Elderly in China.
Horizontal Inequity in Health Care Utilization among the Middle-Aged and Elderly in China.
复制标题
中国中老年人医疗保健利用的横向不平等
DOI：
10.3390/ijerph14080842
复制
发表时间：
2017-07-26
影响因子：
--
通讯作者：
Yin A
中科院分区：
文献类型：
--
作者：
Li C;Dou L;Wang H;Jing S;Yin A
背景：公平利用卫生保健是中国卫生系统的首要目标。本研究旨在考察中国地区中老年人医疗服务利用的横向不公平，并找出造成不公平的因素。方法：数据来源于中国健康与退休纵向研究。我们使用集中度指数(CI)和水平不公平(HI)来衡量卫生服务利用的不公平。使用非线性回归模型将CI分解为各因素的贡献率。结果：门诊就诊概率和总就诊人次的CI分别为0.0642和0.0780，住院就诊概率和总就诊人次的CI分别为0.1418和0.1471。HIS也呈显著阳性。生活水平是最重要的贡献因素。健康保险的缴费在不同的计划中有所不同。结论：本研究支持中国地区中老年人在医疗服务利用概率和频率上存在的亲富不公。缩小生活水平差距和改善老年人健康保险福利一揽子计划应有助于解决这些不平等问题。
Background: Equitable utilization of health care is a primary goal of the Chinese health system. This study aimed to examine horizontal inequity in health care utilization and identify the factors resulting in inequity among the middle-aged and elderly in China. Methods: The data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). We employed the concentration index (CI) and horizontal inequity (HI) to measure inequity in health care utilization. Non-linear regression models were used to decompose the CI into the contribution of each factor. Results: The CIs for the probability of and total number of outpatient visits were 0.0642 and 0.0780, respectively, and those for inpatient visits were 0.1418 and 0.1471, respectively. The HIs were also significantly positive. Living standard was the most important contributor. The contribution of health insurance varied between plans. Conclusions: This study supported the presence of pro-rich inequity in health care utilization for both probability and frequency among the middle-aged and elderly in China. Narrowing the living standard gap and improving the health insurance benefit package for the elderly should help to resolve these inequities.
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