Introduction
Methods
Study design and sample
Indicators
Statistical analysis
Results
Increases in rate of utilisation of CMHS post-reform
Variables | Urban (n = 912) | Rural (n = 1420) | ||||
---|---|---|---|---|---|---|
No | Yes | P | No | Yes | P | |
Healthcare reform | < 0.001 | < 0.001 | ||||
Before | 167(29.61) | 55(15.80) | 336(40.88) | 80(13.38) | ||
After | 397(70.39) | 293(84.20) | 486(59.12) | 518(86.62) | ||
Age (years) | 0.019 | 0.789 | ||||
≤ 25 | 142(25.18) | 104(29.89) | 278(33.82) | 210(35.12) | ||
26–30 | 239(42.38) | 161(46.26) | 258(31.39) | 190(31.77) | ||
≥ 31 | 183(32.45) | 83(23.85) | 286(34.79) | 198(33.11) | ||
Education | 0.025 | < 0.001 | ||||
≤ Primary school | 62(10.99) | 20(5.78) | 250(30.53) | 98(16.39) | ||
Middle school | 272(48.23) | 171(49.42) | 460(56.17) | 381(63.71) | ||
≥ High school | 230(40.78) | 155(44.80) | 109(13.31) | 119(19.90) | ||
Employment | 0.090 | 0.885 | ||||
No | 206(36.52) | 108(31.03) | 126(15.33) | 90(15.05) | ||
Yes | 358(63.48) | 240(68.97) | 696(84.67) | 508(84.95) | ||
Annual personal expenditure (Chinese Yuan) | 0.314 | < 0.001 | ||||
Poorest | 60(10.66) | 30(8.62) | 270(32.89) | 104(17.42) | ||
Poorer | 86(15.28) | 53(15.23) | 192(23.39) | 132(22.11) | ||
Middle | 120(21.31) | 63(18.10) | 144(17.54) | 142(23.79) | ||
Richer | 114(20.25) | 89(25.57) | 140(17.05) | 123(20.60) | ||
Richest | 183(32.50) | 113(32.47) | 75(9.14) | 96(16.08) | ||
Health score | 86.54 ± 8.78 | 88.58 ± 7.61 | < 0.001 | 85.93 ± 9.20 | 87.45 ± 8.39 | < 0.001 |
Health insurance | 0.033 | 0.280 | ||||
No | 92(16.31) | 39(11.21) | 24(2.92) | 12(2.01) | ||
Yes | 472(83.69) | 309(88.79) | 798(97.08) | 586(97.99) | ||
Chronic disease | 0.024 | 0.510 | ||||
No | 536(95.04) | 341(97.99) | 792(96.35) | 580(96.99) | ||
Yes | 28(4.96) | 7(2.01) | 30(3.65) | 18(3.01) | ||
Parity | 0.064 | 0.015 | ||||
1 | 368(65.36) | 248(71.26) | 402(49.14) | 332(55.70) | ||
≥ 2 | 195(34.64) | 100(28.74) | 416(50.86) | 264(44.30) |
Variables | Urban (n = 912) | Rural (n = 1420) | ||||
---|---|---|---|---|---|---|
OR | 95%CL | P | OR | 95%CL | P | |
Healthcare reform | ||||||
Before | 1.00 | 1.00 | ||||
After | 5.02 | 1.90,13.31 | 0.001 | 14.70 | 5.43,39.76 | < 0.001 |
Age (years) | ||||||
≤ 25 | 1.00 | 1.00 | ||||
26–30 | 1.10 | 0.62,1.96 | 0.741 | 1.40 | 0.80,2.44 | 0.239 |
≥ 31 | 0.78 | 0.38,1.59 | 0.493 | 2.49 | 1.23,5.06 | 0.012 |
Education | ||||||
≤ Primary school | 1.00 | 1.00 | ||||
Middle school | 2.62 | 0.98,7.03 | 0.056 | 3.11 | 1.64,5.92 | 0.001 |
≥ High school | 4.18 | 1.30,13.44 | 0.016 | 4.55 | 1.88,11.01 | 0.001 |
Employment | ||||||
No | 1.00 | 1.00 | ||||
Yes | 1.47 | 0.86,2.49 | 0.156 | 1.12 | 0.62,2.03 | 0.697 |
Annual personal expenditure (Chinese Yuan) | ||||||
Poorest | 1.00 | 1.00 | ||||
Poorer | 0.94 | 0.35,2.50 | 0.899 | 1.27 | 0.67,2.41 | 0.454 |
Middle | 0.64 | 0.24,1.67 | 0.357 | 1.70 | 0.85,3.41 | 0.132 |
Richer | 0.96 | 0.37,2.47 | 0.934 | 1.04 | 0.51,2.12 | 0.910 |
Richest | 0.51 | 0.19,1.37 | 0.183 | 1.94 | 0.86,4.39 | 0.112 |
Health score | 1.03 | 1.00,1.07 | 0.051 | 1.02 | 0.99,1.05 | 0.147 |
Health insurance | ||||||
No | 1.00 | 1.00 | ||||
Yes | 2.67 | 1.13,6.30 | 0.026 | 4.25 | 1.00,18.13 | 0.05 |
Chronic disease | ||||||
No | 1.00 | 1.00 | ||||
Yes | 0.35 | 0.08,1.49 | 0.156 | 0.75 | 0.23,2.50 | 0.642 |
Parity | ||||||
1 | 1.00 | 1.00 | ||||
≥ 2 | 0.62 | 0.32,1.20 | 0.155 | 0.40 | 0.21,0.75 | 0.005 |
Improvement in equity of utilisation of CMHS post-reform
Area | Before healthcare reform | After healthcare reform | P | ||||
---|---|---|---|---|---|---|---|
CI | 95% CL | CI | 95% CL | ||||
Lower | Upper | Lower | Upper | ||||
Urban | 0.130 | −0.026 | 0.411 | − 0.041 | − 0.096 | 0.007 | 0.021 |
Rural | 0.104 | −0.012 | 0.222 | 0.019 | − 0.014 | 0.060 | 0.170 |
Variables | Before healthcare reform (n = 222) | After healthcare reform (n = 690) | ||||||
---|---|---|---|---|---|---|---|---|
Elasticity | CI | Contribution to CI | % | Elasticity | CI | Contribution to CI | % | |
Age (years) | ||||||||
≤ 25 | Reference | Reference | ||||||
26–30 | − 0.286 | 0.062 | − 0.018 | −13.70 | 0.080 | 0.033 | 0.002 | −6.42 |
≥ 31 | −0.138 | 0.012 | −0.002 | −1.30 | 0.005 | −0.039 | − 0.0002 | 0.50 |
Education | ||||||||
≤ Primary school | Reference | Reference | ||||||
Middle school | 1.491 | −0.234 | −0.350 | − 268.90 | 0.200 | − 0.077 | − 0.015 | 37.40 |
≥ High school | 2.210 | 0.175 | 0.387 | 297.50 | 0.135 | 0.142 | 0.019 | −46.98 |
Employment | ||||||||
No | Reference | Reference | ||||||
Yes | −0.029 | −0.444 | 0.001 | 0.99 | 0.153 | −0.009 | −0.001 | 3.37 |
Annual personal expenditure (Chinese Yuan) | ||||||||
Poor | Reference | Reference | ||||||
Poorer | 0.055 | −0.069 | −0.004 | −2.96 | − 0.056 | −0.770 | 0.043 | − 105.54 |
Middle | −0.004 | 0.280 | −0.001 | −0.96 | − 0.104 | −0.357 | 0.037 | −90.68 |
Richer | 0.072 | 0.449 | 0.033 | 25.01 | −0.107 | −0.066 | − 0.007 | 17.16 |
Richest | 0.040 | 0.545 | 0.022 | 16.95 | −0.253 | 0.480 | −0.121 | 296.16 |
Health score | 2.961 | 0.005 | 0.014 | 10.47 | 0.621 | 0.003 | 0.002 | −4.74 |
Health insurance | ||||||||
No | Reference | Reference | ||||||
Yes | 0.289 | −0.078 | −0.023 | −17.40 | 0.275 | −0.036 | − 0.010 | 24.08 |
Chronic disease | ||||||||
No | Reference | Reference | ||||||
Yes | −0.012 | 0.029 | − 0.0003 | −0.27 | − 0.012 | −0.202 | 0.002 | −6.04 |
Parity | ||||||||
1 | Reference | Reference | ||||||
≥ 2 | −0.219 | −0.029 | 0.006 | 4.82 | −0.281 | −0.018 | 0.005 | −11.99 |
Needs variables | – | – | −0.006 | −4.80 | – | – | 0.006 | −16.70 |
HI4 | – | – | 0.136 | – | – | – | −0.047 | – |
Variables | Before healthcare reform (n = 416) | After healthcare reform (n = 1004) | ||||||
---|---|---|---|---|---|---|---|---|
Elasticity | CI | Contribution to CI | % | Elasticity | CI | Contribution to CI | % | |
Age (years) | ||||||||
≤ 25 | Reference | Reference | ||||||
26–30 | −0.004 | 0.033 | −0.0001 | −0.14 | 0.031 | −0.014 | − 0.0004 | −2.29 |
≥ 31 | 0.284 | −0.023 | −0.007 | −6.38 | 0.058 | −0.022 | − 0.001 | − 6.69 |
Education | ||||||||
≤ Primary school | Reference | Reference | ||||||
Middle school | 0.350 | 0.029 | 0.010 | 9.70 | 0.160 | −0.011 | −0.002 | −8.87 |
≥ High school | 0.135 | 0.131 | 0.018 | 17.09 | 0.058 | 0.154 | 0.009 | 47.40 |
Employment | ||||||||
No | Reference | Reference | ||||||
Yes | −0.104 | 0.0003 | −0.0001 | − 0.03 | 0.059 | 0.002 | 0.0001 | 0.64 |
Annual personal expenditure (Chinese Yuan) | ||||||||
Poor | Reference | Reference | ||||||
Poorer | 0.048 | 0.288 | 0.014 | 13.29 | 0.005 | −0.413 | −0.002 | −11.71 |
Middle | 0.032 | 0.661 | 0.021 | 20.16 | 0.025 | −0.008 | − 0.002 | −10.57 |
Richer | 0.006 | 0.875 | 0.006 | 5.316 | −0.005 | 0.329 | −0.002 | −9.12 |
Richest | 0.034 | 1.072 | 0.036 | 34.82 | 0.019 | 0.755 | 0.015 | 77.19 |
Health score | −0.005 | −0.001 | 0.000 | 0.004 | 0.620 | 0.002 | 0.001 | 6.33 |
Health insurance | ||||||||
No | Reference | Reference | ||||||
Yes | 0.722 | 0.0004 | 0.0003 | 0.29 | 0.303 | −0.006 | −0.002 | −10.01 |
Parity | ||||||||
1 | Reference | Reference | ||||||
≥2 | −0.918 | −0.005 | 0.004 | 4.22 | −0.315 | −0.003 | 0.001 | 4.38 |
Needs variables | – | – | −0.007 | −6.52 | – | – | −0.0004 | −2.65 |
HI4 | – | – | 0.111 | – | – | – | 0.0194 | – |