The Effect of New Rural Cooperative Medical Scheme on the Socioeconomic Inequality in Inpatient Service Utilization Among the Elderly in China
The Effect of New Rural Cooperative Medical Scheme on the Socioeconomic Inequality in Inpatient Service Utilization Among the Elderly in China
复制标题
新型农村合作医疗对中国老年人住院服务利用社会经济不平等的影响
DOI：
10.2147/rmhp.s252336
复制
发表时间：
2020-01-01
影响因子：
3.5
通讯作者：
Yang, Fan
中科院分区：
文献类型：
--
作者：
Sun, Jian;Lyu, Xiaoyin;Yang, Fan
研究背景与目的健康公平是卫生政策的重要目标，而卫生服务均等化是实现健康公平的重要保障，本研究采用横断面数据，探讨新型农村合作医疗（New Rural Cooperative Medical Scheme，NCMS）对中国老年人住院服务利用社会经济不平等的影响。方法本研究的数据来源于2018年中国家庭追踪研究（CFPS），涉及3645名60岁及以上的老年人。此外，还采用集中度指数和集中度曲线来衡量住院服务利用的社会经济不平等性。采用多元线性回归模型探讨新型农村合作医疗对住院服务利用的影响。此外，本研究采用集中度指数分解法，探讨新型农村合作医疗对住院服务利用社会经济不平等的影响。结果老年人住院费用集中度指数为0.0538，集中度曲线位于对角线下方。回归分析结果表明，老年人住院费用与新型农村合作医疗显著相关（相关系数= 0.8749，p < 0.01）。分解结果显示，新型农村合作医疗对集中度指数的贡献率为-2.29%，表明其对降低住院服务利用中的亲富不平等的贡献有限。结论老年人住院服务利用存在亲富不平等。此外，新型农村合作医疗与较高的住院费用显着相关。此外，新型农村合作医疗在减少住院服务利用中的亲富不平等方面的作用有限。
Background and Aim Health equity is an important goal of health policy, and the equalization of access to health care plays a vital role in guaranteeing it. The aim of this study was to use the cross-sectional data to explore the effect of New Rural Cooperative Medical Scheme (NRCMS) on the socioeconomic inequality in inpatient service utilization among the elderly in china. Methods The data of this study were obtained from the 2018 wave of China Family Panel Studies (CFPS), involving 3645 older adults aged 60 and above. Furthermore, concentration index and concentration curve were employed to measure the socioeconomic inequality in inpatient service utilization. Moreover, this study used multiple linear regression model to explore the effect of NRCMS on inpatient service utilization. In addition, this study adopted the decomposition of concentration index to investigate the effect of NRCMS on the socioeconomic inequality of inpatient service utilization. Results The concentration index of inpatient expense for the older people was 0.0538, and its concentration curve lays below the diagonal. The regression result indicates that NRCMS was significantly associated with higher inpatient expense among the elderly (coefficient = 0.8749, p < 0.01). The decomposition result reveals that the contribution rate of NRCMS to concentration index was −2.29%, which indicates that its contribution on reducing pro-rich inequality in inpatient service utilization was limited. Conclusion This study demonstrates that there was a pro-rich inequality in inpatient service utilization among the elderly. Furthermore, NRCMS was significantly associated with higher inpatient expense. Moreover, NRCMS only played a limited role in reducing pro-rich inequality in inpatient service utilization.