IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v17y2020i22p8697-d449695.html
   My bibliography  Save this article

Status and Factors Associated with Healthcare Choices among Older Adults and Children in an Urbanized County: A Cross-Sectional Study in Kunshan, China

Author

Listed:
  • Yuxi Zhao

    (Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai 200032, China
    China Research Center on Disability Issues at Fudan University, Shanghai 200032, China
    Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai 200032, China
    These authors contributed equally to this work.)

  • Linqi Mao

    (Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai 200032, China
    China Research Center on Disability Issues at Fudan University, Shanghai 200032, China
    Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai 200032, China
    These authors contributed equally to this work.)

  • Jun Lu

    (Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai 200032, China
    China Research Center on Disability Issues at Fudan University, Shanghai 200032, China
    Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai 200032, China)

  • Qi Zhang

    (School of Community and Environmental Health, Old Dominion University, Norfolk, VA 23529, USA)

  • Gang Chen

    (China Research Center on Disability Issues at Fudan University, Shanghai 200032, China
    Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai 200032, China
    Department of Health Law and Inspection, School of Public Health, Fudan University, Shanghai 200032, China)

  • Mei Sun

    (Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai 200032, China
    China Research Center on Disability Issues at Fudan University, Shanghai 200032, China
    Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai 200032, China)

  • Fengshui Chang

    (Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai 200032, China
    China Research Center on Disability Issues at Fudan University, Shanghai 200032, China
    Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai 200032, China)

  • Xiaohong Li

    (Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai 200032, China
    China Research Center on Disability Issues at Fudan University, Shanghai 200032, China
    Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai 200032, China)

Abstract

As important unit for regional health planning, urbanized counties are facing challenges because of internal migrants and aging. This study took urbanized counties in China as cases and two key populations as objects to understand different populations’ intentions of choosing corresponding health service resources and to provide support for resource allocation. A cross-sectional study was conducted in Kunshan, a highly urbanized county in China, in 2016, among older adults aged 60 or over and children aged 0–6. Multinomial logistics models were used to identify the factors associated with healthcare choices. In this study, we found that income, distance of the tertiary provider, and migrant status were not associated with choices of tertiary healthcare outside county for children, while parents’ education level was. The responsiveness of the tertiary provider inside the county was lower than primary and secondary providers inside the county, while respondents were dissatisfied with the medical technology and medical facility for the tertiary inside the county compared to those of the tertiary provider outside the county. Significant differences existed in terms of the perception of different categories of institutions. To conclude, local governments should particularly seek to strengthen pediatric primary health services and improve the responsiveness of healthcare facilities to treat geriatric and pediatric diseases, which also bring significance to the developing countries in the process of urbanization.

Suggested Citation

  • Yuxi Zhao & Linqi Mao & Jun Lu & Qi Zhang & Gang Chen & Mei Sun & Fengshui Chang & Xiaohong Li, 2020. "Status and Factors Associated with Healthcare Choices among Older Adults and Children in an Urbanized County: A Cross-Sectional Study in Kunshan, China," IJERPH, MDPI, vol. 17(22), pages 1-12, November.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:22:p:8697-:d:449695
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/17/22/8697/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/17/22/8697/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Van der Heyden, J. H. A. & Demarest, S. & Tafforeau, J. & Van Oyen, H., 2003. "Socio-economic differences in the utilisation of health services in Belgium," Health Policy, Elsevier, vol. 65(2), pages 153-165, August.
    2. Mumuni Abu & Samuel Nii Ardey Codjoe, 2018. "Experience and Future Perceived Risk of Floods and Diarrheal Disease in Urban Poor Communities in Accra, Ghana," IJERPH, MDPI, vol. 15(12), pages 1-16, December.
    3. Huajie Yang & Xiang Huang & Zhiheng Zhou & Harry H X Wang & Xinyue Tong & Zhihong Wang & Jiaji Wang & Zuxun Lu, 2014. "Determinants of Initial Utilization of Community Healthcare Services among Patients with Major Non-Communicable Chronic Diseases in South China," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-15, December.
    4. Yun Liu & Qingxia Kong & Shasha Yuan & Joris van de Klundert, 2018. "Factors influencing choice of health system access level in China: A systematic review," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-21, August.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hoeck, Sarah & François, Guido & Van der Heyden, Johan & Geerts, Joanna & Van Hal, Guido, 2011. "Healthcare utilisation among the Belgian elderly in relation to their socio-economic status," Health Policy, Elsevier, vol. 99(2), pages 174-182, February.
    2. Wang, Tianyu & Wen, Ke & Gao, Qiuming & Sun, Ruochen, 2023. "Small money, big change: The distributional impact of differentiated doctor's visit fee on healthcare utilization," Social Science & Medicine, Elsevier, vol. 339(C).
    3. Xiuli Wang & Barnabas C. Seyler & Ting Chen & Weiyan Jian & Hongqiao Fu & Baofeng Di & Winnie Yip & Jay Pan, 2024. "Disparity in healthcare seeking behaviors between impoverished and non-impoverished populations with implications for healthcare resource optimization," Palgrave Communications, Palgrave Macmillan, vol. 11(1), pages 1-12, December.
    4. Yanhong Gong & Xiaoxv Yin & Yunxia Wang & Yongbin Li & Geng Qin & Liqun Liu & Wei Zhou & Fujian Song & Xiaoxin Dong & Shiyi Cao & Chen Yang & Huajie Yang & Jun Xie & Junan Liu & Zuxun Lu, 2014. "Social Determinants of Community Health Services Utilization among the Users in China: A 4-Year Cross-Sectional Study," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-7, May.
    5. Jia, Peng & Wang, Youfa & Yang, Min & Wang, Limin & Yang, Xuchao & Shi, Xinyu & Yang, Lijian & Wen, Jin & Liu, Yi & Yang, Maokang & Xin, Junguo & Zhang, Fengying & Jiang, Lihua & Chi, Chunhua & Zhang,, 2022. "Inequalities of spatial primary healthcare accessibility in China," Social Science & Medicine, Elsevier, vol. 314(C).
    6. Liu, Yun & Kong, Qingxia & de Bekker-Grob, Esther W., 2019. "Public preferences for health care facilities in rural China: A discrete choice experiment," Social Science & Medicine, Elsevier, vol. 237(C), pages 1-1.
    7. Wei, Zhongyu & Bai, Jianjun & Feng, Ruitao, 2023. "Optimization referral rate design for hierarchical diagnosis and treatment system based on accessibility-utilization efficiency bi-objective collaboration: A case study of China," Social Science & Medicine, Elsevier, vol. 322(C).
    8. Bakhtiar Piroozi & Arash Rashidian & Amirhossein Takian & Mohammad Amerzadeh & Minoo Alipouri Sakha & Obeidollah Faraji & Ghobad Moradi, 2019. "The impact of health transformation plan on hospitalization rates in Iran: An interrupted time series," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 264-273, January.
    9. van de Klundert, Joris & Cominetti, Roberto & Liu, Yun & Kong, Qingxia, 2024. "The interdependence between hospital choice and waiting time — with a case study in urban China," Journal of choice modelling, Elsevier, vol. 52(C).
    10. Jingya Luan & Yuhong Tian & Chi Yung Jim & Xu Liu & Mengxuan Yan & Lizhu Wu, 2023. "Assessing Spatial Accessibility of Community Hospitals for the Elderly in Beijing, China," IJERPH, MDPI, vol. 20(1), pages 1-19, January.
    11. Helen. C. Nnadi & Onyinyechi. G. Ossai & Victor C. Nwokocha, 2024. "Urbanization factors and the vagaries of the rural health care industry in Nigeria: an analysis of the accessibility of healthcare services by older adults in the Nsukka Local Government Area," Palgrave Communications, Palgrave Macmillan, vol. 11(1), pages 1-9, December.
    12. Xiang Huang & Huajie Yang & Harry H.X. Wang & Yongjun Qiu & Xiujuan Lai & Zhiheng Zhou & Fangjian Li & Liwei Zhang & Jiaji Wang & Jimin Lei, 2015. "The Association Between Physical Activity, Mental Status, and Social and Family Support with Five Major Non-Communicable Chronic Diseases Among Elderly People: A Cross-Sectional Study of a Rural Popul," IJERPH, MDPI, vol. 12(10), pages 1-15, October.
    13. Wei, Zhongyu & Bai, Jianjun & Feng, Ruitao, 2022. "Evaluating the spatial accessibility of medical resources taking into account the residents' choice behavior of outpatient and inpatient medical treatment," Socio-Economic Planning Sciences, Elsevier, vol. 83(C).
    14. Gundgaard, Jens & Lauridsen, Jørgen, 2013. "Explaining the Sources of IncomeRelated Inequality in Health Care Utilization in Denmark," DaCHE discussion papers 2013:1, University of Southern Denmark, Dache - Danish Centre for Health Economics.
    15. Zhou, Zhongliang & Zhao, Yaxin & Shen, Chi & Lai, Sha & Nawaz, Rashed & Gao, Jianmin, 2021. "Evaluating the effect of hierarchical medical system on health seeking behavior: A difference-in-differences analysis in China," Social Science & Medicine, Elsevier, vol. 268(C).
    16. Jiang, Shan & Gu, Yuanyuan & Yang, Fan & Wu, Tao & Wang, Hui & Cutler, Henry & Zhang, Lufa, 2020. "Tertiary hospitals or community clinics? An enquiry into the factors affecting patients' choice for healthcare facilities in urban China," China Economic Review, Elsevier, vol. 63(C).
    17. Erik Schokkaert & Carine Van de Voorde, 2005. "Health care reform in Belgium," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 25-39, September.
    18. Shuduo Zhou & Jin Xu & Xiaochen Ma & Beibei Yuan & Xiaoyun Liu & Hai Fang & Qingyue Meng, 2020. "How Can One Strengthen a Tiered Healthcare System through Health System Reform? Lessons Learnt from Beijing, China," IJERPH, MDPI, vol. 17(21), pages 1-14, October.
    19. Jiang, Wei & Chen, Qiulin & Lou, Xuyan & Song, Lina & Chen, Zhuo, 2024. "Impact of a health system vertical integration program on patient expenditures and healthcare utilization: Evidence from county hospitals in East China," China Economic Review, Elsevier, vol. 87(C).
    20. Carla Blázquez Fernández & David Cantarero-Prieto & Patricio Perez, 2024. "Did the Great Recession matter for health care utilization? An approach from the working-age population in Spain," Economics and Business Letters, Oviedo University Press, vol. 13(3), pages 122-131.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:17:y:2020:i:22:p:8697-:d:449695. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.