Vol 9: Identifying Determinants of Socioeconomic Inequality in Health Service Utilization among Patients with Chronic Non-Communicable Diseases in China.Report as inadecuate



 Vol 9: Identifying Determinants of Socioeconomic Inequality in Health Service Utilization among Patients with Chronic Non-Communicable Diseases in China.


Vol 9: Identifying Determinants of Socioeconomic Inequality in Health Service Utilization among Patients with Chronic Non-Communicable Diseases in China. - Download this document for free, or read online. Document in PDF available to download.

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This article is from PLoS ONE, volume 9.AbstractBackground: People with chronic non-communicable diseases NCD are particularly vulnerable to socioeconomic inequality due to their long-term expensive health needs. This study aimed to assess socioeconomic-related inequality in health service utilization among NCD patients in China and to analyze factors associated with this disparity. Methods: Data were taken from the 2008 Chinese National Health Survey, in which a multiple stage stratified random sampling method was employed to survey 56,456 households. We analyzed the distribution of actual use, need-expected use, and need-standardized usage of outpatient services over a two-week period and inpatient services over one-year across different income groups in 27,233 adult respondents who reported as having a NCD. We used a concentration index to measure inequality in the distribution of health services, which was expressed as HI Horizontal Inequity Index for need-standardized use of services. A non-linear probit regression model was employed to detect inequality across socio-economic groups. Results: Pro-rich inequity in health services among NCD patients was more substantial than the average population. A higher degree of pro-rich inequity HI = 0.253 was found in inpatient services compared to outpatient services HI = 0.089. Despite a greater need for health services amongst those of lower socio-economic status, their actual use is much less than their more affluent counterparts. Health service underuse by the poor and overuse by the affluent are evident. Household income disparity was the greatest inequality factor in NCD service use for both outpatients 71.3% and inpatients 108%, more so than health insurance policies. Some medical insurance schemes, such as the MIUE, actually made a pro-rich contribution to health service inequality 16.1% for outpatient and 12.1% for inpatient. Conclusions: Inequality in health services amongst NCD patients in China remains largely determined by patient financial capability. The current insurance schemes are insufficient to address this inequity. A comprehensive social policy that encompasses a more progressive taxation package and redistribution of social capital as well as pro-poor welfare is needed.



Author: Xie, Xin; Wu, Qunhong; Hao, Yanhua; Yin, Hui; Fu, Wenqi; Ning, Ning; Xu, Ling; Liu, Chaojie; Li, Ye; Kang, Zheng; He, Changzhi; Liu, Guoxiang

Source: https://archive.org/







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