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Horizontal Inequity in Health Care Utilization among the Middle-Aged and Elderly in China

Author

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  • Chaofan Li

    (School of Health Care Management, Key Laboratory of Health Economics and Policy Research, NHFPC, Shandong University, No. 44 Wenhua Road, Jinan 250012, China)

  • Lei Dou

    (School of Health Care Management, Key Laboratory of Health Economics and Policy Research, NHFPC, Shandong University, No. 44 Wenhua Road, Jinan 250012, China)

  • Haipeng Wang

    (School of Health Care Management, Key Laboratory of Health Economics and Policy Research, NHFPC, Shandong University, No. 44 Wenhua Road, Jinan 250012, China)

  • Shanshan Jing

    (School of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, China)

  • Aitian Yin

    (School of Health Care Management, Key Laboratory of Health Economics and Policy Research, NHFPC, Shandong University, No. 44 Wenhua Road, Jinan 250012, China)

Abstract

Background: Equitable utilization of health care is a primary goal of the Chinese health system. This study aimed to examine horizontal inequity in health care utilization and identify the factors resulting in inequity among the middle-aged and elderly in China. Methods: The data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). We employed the concentration index (CI) and horizontal inequity (HI) to measure inequity in health care utilization. Non-linear regression models were used to decompose the CI into the contribution of each factor. Results: The CIs for the probability of and total number of outpatient visits were 0.0642 and 0.0780, respectively, and those for inpatient visits were 0.1418 and 0.1471, respectively. The HIs were also significantly positive. Living standard was the most important contributor. The contribution of health insurance varied between plans. Conclusions: This study supported the presence of pro-rich inequity in health care utilization for both probability and frequency among the middle-aged and elderly in China. Narrowing the living standard gap and improving the health insurance benefit package for the elderly should help to resolve these inequities.

Suggested Citation

  • Chaofan Li & Lei Dou & Haipeng Wang & Shanshan Jing & Aitian Yin, 2017. "Horizontal Inequity in Health Care Utilization among the Middle-Aged and Elderly in China," IJERPH, MDPI, vol. 14(8), pages 1-13, July.
    • Handle: RePEc:gam:jijerp:v:14:y:2017:i:8:p:842-:d:105994
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    References listed on IDEAS

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    2. Hongyun Zhou & Jiqing Hong & Su Yang & Yuxuan Huang, 2022. "The Impact of Social Capital on Rural Residents’ Medical Service Utilization in China—An Empirical Study Based on CFPS Data," IJERPH, MDPI, vol. 19(23), pages 1-19, November.
    3. Yunhan Wang & Nan Jiang & Haiya Shao & Zhonghua Wang, 2024. "Exploring unmet healthcare needs and associated inequalities among middle-aged and older adults in Eastern China during the progression toward universal health coverage," Health Economics Review, Springer, vol. 14(1), pages 1-12, December.
    4. Huiru Zhang & Fanli Meng & Mingsheng Chen, 2023. "Socioeconomic Inequality and Associated Factors Affecting Health Care Utilization among the Elderly: Evidence from the China Health and Retirement Longitudinal Study," Sustainability, MDPI, vol. 15(9), pages 1-13, May.
    5. Jiaoling Huang & Li Yuan & Hong Liang, 2020. "Which Matters for Medical Utilization Equity under Universal Coverage: Insurance System, Region or SES," IJERPH, MDPI, vol. 17(11), pages 1-17, June.
    6. Xiaotong Wen & Huilie Zheng & Zhenyi Feng & Winter Tucker & Yuanan Lu & Zhaokang Yuan, 2019. "Hospitalization Services Utilization Between Permanent and Migrant Females in Underdeveloped Rural Regions and Contributing Factors—A Five-Time Data Collection and Analysis," IJERPH, MDPI, vol. 16(18), pages 1-16, September.

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