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Changes in Perceived Accessibility to Healthcare from the Elderly between 2005 and 2014 in China: An Oaxaca–Blinder Decomposition Analysis

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  • Tao Zhang

    (Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 43003, China)

  • Jing Liu

    (Department of Health Information Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 43003, China)

  • Chaojie Liu

    (School of Psychology and Public Health, La Trobe University, Melbourne 3086, Australia)

Abstract

Elderly people are characterized with high needs for healthcare, accompanied by high barriers in access to healthcare. This study aimed to identify temporal changes in access to healthcare and determinants of such changes from the elderly in China, over the period between 2005 and 2014. Two waves (2005 and 2014) of data were extracted from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), measuring changes in perceived accessibility to healthcare when needed by the elderly (≥65 years). The effects of the explanatory variables (need, predisposing and enabling factors) on the changes were divided into two components using the Oaxaca–Blinder decomposition method: (1) the endowment portion as a result of distribution differences of the explanatory variables and (2) the coefficient portion as a result of differential responses of the dependent variable to the explanatory variables. Perceived accessibility to healthcare from the elderly increased from 89.6% in 2005 to 96.7% in 2014. The coefficient portion (82%) contributed more to the change than the endowment portion (63%) after adjustments for a negative interaction effect (−45%) between the two. Lower perceived accessibility was associated with older age, lower income, lower affordability of daily expenses and lower insurance coverage. But the coefficient effects suggested that their impacts on perceived accessibility to healthcare declined over time. By contrast, the impacts of gender and out-of-pocket payment ratio for medical care on perceived accessibility to healthcare increased over time. Perceived accessibility to healthcare from the elderly improved between 2005 and 2014. Gender gaps are closing. But the increased effect of out-of-pocket medical payments on perceived accessibility to healthcare deserves further investigation and policy interventions.

Suggested Citation

  • Tao Zhang & Jing Liu & Chaojie Liu, 2019. "Changes in Perceived Accessibility to Healthcare from the Elderly between 2005 and 2014 in China: An Oaxaca–Blinder Decomposition Analysis," IJERPH, MDPI, vol. 16(20), pages 1-12, October.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:20:p:3824-:d:275000
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    References listed on IDEAS

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    1. Oaxaca, Ronald, 1973. "Male-Female Wage Differentials in Urban Labor Markets," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 14(3), pages 693-709, October.
    2. Cheng, Lingguo & Liu, Hong & Zhang, Ye & Zhao, Zhong, 2018. "The health implications of social pensions: Evidence from China's new rural pension scheme," Journal of Comparative Economics, Elsevier, vol. 46(1), pages 53-77.
    3. Luo, Juhua & Zhang, Xiulan & Jin, Chenggang & Wang, Dongmin, 2009. "Inequality of access to health care among the urban elderly in northwestern China," Health Policy, Elsevier, vol. 93(2-3), pages 111-117, December.
    4. Fairlie, Robert W., 2003. "An Extension of the Blinder-Oaxaca Decomposition Technique to Logit and Probit Models," Center Discussion Papers 28425, Yale University, Economic Growth Center.
    5. Zhongwei Zhao, 2006. "Income Inequality, Unequal Health Care Access, and Mortality in China," Population and Development Review, The Population Council, Inc., vol. 32(3), pages 461-483, September.
    6. Thomas Bauer & Mathias Sinning, 2008. "An extension of the Blinder–Oaxaca decomposition to nonlinear models," AStA Advances in Statistical Analysis, Springer;German Statistical Society, vol. 92(2), pages 197-206, May.
    7. Parslow, Ruth & Jorm, Anthony & Christensen, Helen & Jacomb, Patricia & Rodgers, Bryan, 2004. "Gender differences in factors affecting use of health services: an analysis of a community study of middle-aged and older Australians," Social Science & Medicine, Elsevier, vol. 59(10), pages 2121-2129, November.
    8. Xin Meng & Xiaodong Gong & Youjuan Wang, 2009. "Impact of Income Growth and Economic Reform on Nutrition Availability in Urban China: 1986-2000," Economic Development and Cultural Change, University of Chicago Press, vol. 57(2), pages 261-295, January.
    9. Gao, Jun & Raven, Joanna H. & Tang, Shenglan, 2007. "Hospitalisation among the elderly in urban China," Health Policy, Elsevier, vol. 84(2-3), pages 210-219, December.
    10. Yan Jiang & Yu Wang & Le Zhang & Yang Li & Xiaojun Wang & Shuangge Ma, 2013. "Access to Healthcare and Medical Expenditure for the Middle-Aged and Elderly: Observations from China," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-10, May.
    11. Cylus, Jonathan & Papanicolas, Irene, 2015. "An analysis of perceived access to health care in Europe: How universal is universal coverage?," Health Policy, Elsevier, vol. 119(9), pages 1133-1144.
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    2. Yue Li & Chengmeng Zhang & Yan Tong & Yalu Zhang & Gong Chen, 2022. "Prediction of the Old-Age Dependency Ratio in Chinese Cities Using DMSP/OLS Nighttime Light Data," IJERPH, MDPI, vol. 19(12), pages 1-23, June.

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