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Rural-urban disparities in unmet long-term care needs in China: The role of the hukou status

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  • Zhu, Yumei
  • Österle, August

Abstract

This article studies rural-urban disparities in unmet long-term care (LTC) needs in China. Firstly, it investigates the prevalence of unmet LTC needs for three populations which differ according to the extent of LTC needs. Secondly, it examines the impact of having rural or urban hukou registration status and rural or urban residence. The analysis is based on the China Health and Retirement Longitudinal Study (CHARLS) 2013. The broadly, intermediately and narrowly defined LTC population comprises, respectively, 3,682, 1002 and 446 functionally disabled people aged 45 and older. The role of hukou status and rural/urban residence on unmet needs are examined by applying four logistic regression models for each population. We find that rural hukou holders are significantly more likely to have unmet needs in all three populations regardless of their residency. With narrower definitions of the population in need of care, the effects of rural hukou status on unmet needs strengthen. In contrast to earlier studies, our results indicate that it is hukou status rather than place of residence which exacerbates rural-urban disparities in unmet LTC needs. Reducing unmet LTC needs and existing rural-urban disparities therefore requires not only more universal LTC coverage, but also a reduction of the specific access barriers arising from the hukou system.

Suggested Citation

  • Zhu, Yumei & Österle, August, 2017. "Rural-urban disparities in unmet long-term care needs in China: The role of the hukou status," Social Science & Medicine, Elsevier, vol. 191(C), pages 30-37.
  • Handle: RePEc:eee:socmed:v:191:y:2017:i:c:p:30-37
    DOI: 10.1016/j.socscimed.2017.08.025
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    References listed on IDEAS

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    1. Afridi, Farzana & Li, Sherry Xin & Ren, Yufei, 2015. "Social identity and inequality: The impact of China's hukou system," Journal of Public Economics, Elsevier, vol. 123(C), pages 17-29.
    2. García-Gómez, Pilar & Hernández-Quevedo, Cristina & Jiménez-Rubio, Dolores & Oliva-Moreno, Juan, 2015. "Inequity in long-term care use and unmet need: Two sides of the same coin," Journal of Health Economics, Elsevier, vol. 39(C), pages 147-158.
    3. Momtaz, Yadollah Abolfathi & Hamid, Tengku Aizan & Ibrahim, Rahimah, 2012. "Unmet needs among disabled elderly Malaysians," Social Science & Medicine, Elsevier, vol. 75(5), pages 859-863.
    4. Yu, Hao, 2015. "Universal health insurance coverage for 1.3 billion people: What accounts for China's success?," Health Policy, Elsevier, vol. 119(9), pages 1145-1152.
    5. Lei, Xiaoyan & Sun, Xiaoting & Strauss, John & Zhao, Yaohui & Yang, Gonghuan & Hu, Perry & Hu, Yisong & Yin, Xiangjun, 2014. "Reprint of: Health outcomes and socio-economic status among the mid-aged and elderly in China: Evidence from the CHARLS national baseline data," The Journal of the Economics of Ageing, Elsevier, vol. 4(C), pages 59-73.
    6. Koike, Soichi & Furui, Yuji, 2013. "Long-term care-service use and increases in care-need level among home-based elderly people in a Japanese urban area," Health Policy, Elsevier, vol. 110(1), pages 94-100.
    7. Liu, Zhiqiang, 2005. "Institution and inequality: the hukou system in China," Journal of Comparative Economics, Elsevier, vol. 33(1), pages 133-157, March.
    8. Mitchell P. LaPlante & H. Stephen Kaye & Taewoon Kang & Charlene Harrington, 2004. "Unmet Need for Personal Assistance Services: Estimating the Shortfall in Hours of Help and Adverse Consequences," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 59(2), pages 98-108.
    9. Lei, Xiaoyan & Sun, Xiaoting & Strauss, John & Zhao, Yaohui & Yang, Gonghuan & Hu, Perry & Hu, Yisong & Yin, Xiangjun, 2014. "Health outcomes and socio-economic status among the mid-aged and elderly in China: Evidence from the CHARLS national baseline data," The Journal of the Economics of Ageing, Elsevier, vol. 3(C), pages 29-43.
    10. Tennstedt, Sharon & McKinlay, John & Kasten, Linda, 1994. "Unmet need among disabled elders: A problem in access to community long term care?," Social Science & Medicine, Elsevier, vol. 38(7), pages 915-924, April.
    11. Peng, Rong & Ling, Li & He, Qun, 2010. "Self-rated health status transition and long-term care need, of the oldest Chinese," Health Policy, Elsevier, vol. 97(2-3), pages 259-266, October.
    12. Lei Kuang & Li Liu, 2012. "Discrimination against Rural-to-Urban Migrants: The Role of the Hukou System in China," PLOS ONE, Public Library of Science, vol. 7(11), pages 1-8, November.
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    Cited by:

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    2. Lei, Xiaoyan & Bai, Chen & Hong, Jingpeng & Liu, Hong, 2022. "Long-term care insurance and the well-being of older adults and their families: Evidence from China," Social Science & Medicine, Elsevier, vol. 296(C).
    3. Kang, Lili & Zhao, Guangchuan, 2022. "Financial support for unmet need for personal assistance with daily activities: Implications from China's long-term care insurance pilots," Finance Research Letters, Elsevier, vol. 45(C).
    4. Ouyang, Yanyan & Cai, Hongbo & Yu, Xuefei & Li, Zijian, 2022. "Capitalization of social infrastructure into China's urban and rural housing values: Empirical evidence from Bayesian Model Averaging," Economic Modelling, Elsevier, vol. 107(C).
    5. Luo, Yanan & Yuan, Kexin & Li, Yuxiao & Liu, Yating & Pan, Yao, 2024. "The “spillover effect” of long-term care insurance in China on spouses’ health and well-being," Social Science & Medicine, Elsevier, vol. 340(C).
    6. Feng, Jin & Wang, Zhen & Yu, Yangyang, 2020. "Does long-term care insurance reduce hospital utilization and medical expenditures? Evidence from China," Social Science & Medicine, Elsevier, vol. 258(C).
    7. Yumei Zhu & August Österle, 2019. "China's policy experimentation on long‐term care insurance: Implications for access," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1661-1674, October.

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