Skip to main content
main-content

01.12.2018 | Research | Ausgabe 1/2018 Open Access

International Journal for Equity in Health 1/2018

Influencing factors of inequity in health services utilization among the elderly in China

Zeitschrift:
International Journal for Equity in Health > Ausgabe 1/2018
Autoren:
Xianzhi Fu, Nan Sun, Fei Xu, Jin Li, Qixin Tang, Junjian He, Dongdong Wang, Changqing Sun
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12939-018-0861-6) contains supplementary material, which is available to authorized users.

Abstract

Background

With the rise of the aging population, it is particularly important for health services to be used fairly and reasonably in the elderly. This study aimed to assess the present inequality and horizontal inequity for health service use among the elderly in China and to identify the main determinants associated with the disparity.

Methods

This cross-sectional study was based on the sample of the survey of the China Health and Retirement Longitudinal Study (CHARLS) for 2015. The elderly was defined as individuals aged 60 and above, with a total of 7836 participants. We used the concentration index (CI) and the horizontal inequity (HI) to measure the inequity of the utilization of health services. The method of concentration index decomposition was utilized to measure the contribution of various influential factors to the overall unfairness.

Results

The CI for the probability and the frequency of outpatient use were 0.1102 and 0.1015, respectively, and the corresponding values of inpatient use were 0.2777 and 0.2980, respectively. The household consumption expenditure disparity was the greatest inequality factor favoring the better-off. The Urban Employee Basic Medical Insurance made a pro-wealth contribution to inequality in frequency of health services utilization (17.58% for outpatient and 13.40% for inpatient). The contributions of New Rural Cooperative Medical Scheme on reducing unfairness in inpatient use were limited (− 2.23% for probability of inpatient use and − 5.89% for frequency of inpatient use).

Conclusions

There was a strong pro-rich inequality in both the probability and the frequency of use for health services among the elderly in China. The medical insurance was not enough to address this inequity, and different medical insurance schemes had different effects on the unfairness of health service utilization.
Zusatzmaterial
Additional file 1: Table S1. The comparison of demographic characteristics between the elderly using outpatient services and those not using outpatient services, China, 2015. Table S2. The comparison of demographic characteristics between the elderly using inpatient services and those not using inpatient services, China, 2015. Table S3. Contribution to inequalities in the probability of outpatient service utilization, China, 2015. Table S4. Contribution to inequalities in the frequency of outpatient service utilization, China, 2015. Table S5. Contribution to inequalities in the probability of inpatient service utilization, China, 2015. Table S6. Contribution to inequalities in the frequency of inpatient service utilization, China, 2015. (DOCX 54 kb)
12939_2018_861_MOESM1_ESM.docx
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2018

International Journal for Equity in Health 1/2018 Zur Ausgabe