IDEAS home Printed from https://ideas.repec.org/a/pal/palcom/v11y2024i1d10.1057_s41599-024-03712-z.html
   My bibliography  Save this article

Disparity in healthcare seeking behaviors between impoverished and non-impoverished populations with implications for healthcare resource optimization

Author

Listed:
  • Xiuli Wang

    (Sichuan University
    Sichuan University)

  • Barnabas C. Seyler

    (Chengdu Shude High School
    Sichuan University)

  • Ting Chen

    (Sichuan University
    Sichuan University)

  • Weiyan Jian

    (Peking University Health Science Center)

  • Hongqiao Fu

    (Peking University)

  • Baofeng Di

    (Sichuan University- Hong Kong Polytechnic University)

  • Winnie Yip

    (Harvard T.H. Chan School of Public Health)

  • Jay Pan

    (Sichuan University
    Sichuan University)

Abstract

Globally, poverty and illness are linked, attracting widespread attention. In China, illness contributes to about 40% of rural poverty. This study sought to investigate how healthcare-seeking behavior differs between impoverished and non-impoverished populations within the same Chinese healthcare delivery system. It also sought to understand how differences should be considered when assessing spatial accessibility to provide more accurate recommendations for healthcare resource optimization and promote village revitalization and health equity in China. Methodologically, a survey conducted in May 2019 in Enshi Prefecture (a national impoverished region in Hubei Province, China) collected data on healthcare resource utilization regarding the inpatient and outpatient needs of both impoverished and non-impoverished populations. A Chi-square test compared their respective healthcare-seeking behaviors in three respects (e.g., preference for healthcare institution type, transportation mode, and travel time). Baidu Map data with healthcare institution locations and real-life travel times were then incorporated to assess spatial access to different types of healthcare institutions. Results showed that in Enshi, the most widespread village clinics (low-level) were generally the most utilized healthcare institutions for outpatient visits, with patients usually walking for about 30 min. The middle-level Township Health Centers (THCs) and high-level public hospitals were the most used for inpatient visits, with patients willing to drive up to 30 min to THCs and 60 min to hospitals. Comparatively, the impoverished have more frequent service demands but tend to choose lower-level healthcare institutions, with longer travel times and limited transportation modes. Although 75% of Enshi’s area was covered within 30 min by village clinics and 51% of the villages were within 60 min’ drive to hospitals, considerable areas remain under-served compared with the shortest travel time targets in China. In conclusion, spatial access to healthcare resources in Enshi must be further improved, especially by strengthening the service capacity of primary healthcare institutions to address the healthcare needs of Enshi’s impoverished population. The disparity in healthcare-seeking behavior between different population groups should be fully considered to effectively allocate limited healthcare resources to promote health equity for vulnerable populations as proposed in international and domestic policies.

Suggested Citation

  • 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.
    • Handle: RePEc:pal:palcom:v:11:y:2024:i:1:d:10.1057_s41599-024-03712-z
    DOI: 10.1057/s41599-024-03712-z
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1057/s41599-024-03712-z
    File Function: Abstract
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1057/s41599-024-03712-z?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Kaushalendra Kumar & Ashish Singh & Santosh Kumar & Faujdar Ram & Abhishek Singh & Usha Ram & Joel Negin & Paul R Kowal, 2015. "Socio-Economic Differentials in Impoverishment Effects of Out-of-Pocket Health Expenditure in China and India: Evidence from WHO SAGE," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-19, August.
    2. Pan, Jay & Zhao, Hanqing & Wang, Xiuli & Shi, Xun, 2016. "Assessing spatial access to public and private hospitals in Sichuan, China: The influence of the private sector on the healthcare geography in China," Social Science & Medicine, Elsevier, vol. 170(C), pages 35-45.
    3. Hanjie Wang & Qiran Zhao & Yunli Bai & Linxiu Zhang & Xiaohua Yu, 2020. "Poverty and Subjective Poverty in Rural China," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 150(1), pages 219-242, July.
    4. Wang, Xiuli & Yang, Huazhen & Duan, Zhanqi & Pan, Jay, 2018. "Spatial accessibility of primary health care in China: A case study in Sichuan Province," Social Science & Medicine, Elsevier, vol. 209(C), pages 14-24.
    5. 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.
    6. Lu Zhang & Yannan Zhao, 2021. "Breaking the Vicious Cycle between Illness and Poverty: Empirical Actions on Land Use in an Oasis Agricultural Area," Land, MDPI, vol. 10(4), pages 1-13, March.
    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. 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).
    2. Ting Chen & Jay Pan, 2022. "The Effect of Spatial Access to Primary Care on Potentially Avoidable Hospitalizations of the Elderly: Evidence from Chishui City, China," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 160(2), pages 645-665, April.
    3. 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.
    4. 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).
    5. 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.
    6. Lu, Liyong & Pan, Jay, 2019. "The association of hospital competition with inpatient costs of stroke: Evidence from China," Social Science & Medicine, Elsevier, vol. 230(C), pages 234-245.
    7. Shen, Chi & Lai, Sha & Deng, Qiwei & Cao, Dan & Zhao, Dantong & Zhao, Yaxin & Zhou, Zhongliang & Dong, Wanyue & Chen, Xi, 2023. "Do Primary Healthcare Facilities in More Remote Areas Provide More Medical Services? Spatial Evidence from Rural Western China," GLO Discussion Paper Series 1309, Global Labor Organization (GLO).
    8. Rajko Tomaš, 2022. "Measurement of the Concentration of Potential Quality of Life in Local Communities," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 163(1), pages 79-109, August.
    9. Zhao, Chunkai & Chen, Boou & Song, Zhiyong, 2024. "School nutritious feeding and cognitive abilities of students in poverty: Evidence from the nutrition improvement program in China," Children and Youth Services Review, Elsevier, vol. 159(C).
    10. Rahman, Md Mizanur & Jung, Jenny & Islam, Md Rashedul & Rahman, Md Mahfuzur & Nakamura, Ryota & Akter, Shamima & Sato, Motohiro, 2022. "Global, regional, and national progress in financial risk protection towards universal health coverage, 2000–2030," Social Science & Medicine, Elsevier, vol. 312(C).
    11. Chen, Shaohua & Ravallion, Martin, 2021. "Reconciling the conflicting narratives on poverty in China," Journal of Development Economics, Elsevier, vol. 153(C).
    12. Huotari, Tiina & Antikainen, Harri & Keistinen, Timo & Rusanen, Jarmo, 2017. "Accessibility of tertiary hospitals in Finland: A comparison of administrative and normative catchment areas," Social Science & Medicine, Elsevier, vol. 182(C), pages 60-67.
    13. Bec, Caroline & Wells, Geoff & Solomon, Josh, 2020. "Structural barriers to health-provider training programmes for ethnic minorities: the case of the Katu and diabetes management in Vietnam," SocArXiv s78xa_v1, Center for Open Science.
    14. Jay Dev Dubey, 2021. "Measuring Income Elasticity of Healthcare-Seeking Behavior in India: A Conditional Quantile Regression Approach," Journal of Quantitative Economics, Springer;The Indian Econometric Society (TIES), vol. 19(4), pages 767-793, December.
    15. 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).
    16. Xia, Fangzhou & Huang, Jing & Zhang, Zhengfeng, 2024. "Government concerns, the benefit cliff, and land use: A comparative study of rural impoverished and marginalised impoverished groups," Land Use Policy, Elsevier, vol. 140(C).
    17. Haiyan Jia & Xiaoyu Sai & Yangyue Su & Ying Huang, 2022. "Measurement and Decomposition of the Health Poverty of Rural Residents in China," IJERPH, MDPI, vol. 19(19), pages 1-20, October.
    18. Hui-Ching Wu & Ming-Hseng Tseng & Chuan-Chao Lin, 2020. "Assessment on Distributional Fairness of Physical Rehabilitation Resource Allocation: Geographic Accessibility Analysis Integrating Google Rating Mechanism," IJERPH, MDPI, vol. 17(20), pages 1-21, October.
    19. Kan Wang & Jianjun Bai & Xing Dang, 2020. "Spatial Difference and Equity Analysis for Accessibility to Three-Level Medical Services Based on Actual Medical Behavior in Shaanxi, China," IJERPH, MDPI, vol. 18(1), pages 1-20, December.
    20. Verónica Amarante & Maira Colacce & Federico Scalese, 2024. "Poverty in Latin America: feelings/perceptions Vs. material conditions," Documentos de Trabajo (working papers) 24-01, Instituto de Economía - IECON.

    More about this item

    Statistics

    Access and download statistics

    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:pal:palcom:v:11:y:2024:i:1:d:10.1057_s41599-024-03712-z. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: https://www.nature.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.