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Social Determinants of Community Health Services Utilization among the Users in China: A 4-Year Cross-Sectional Study

Author

Listed:
  • 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

Abstract

Background: To identify social factors determining the frequency of community health service (CHS) utilization among CHS users in China. Methods: Nationwide cross-sectional surveys were conducted in 2008, 2009, 2010, and 2011. A total of 86,116 CHS visitors selected from 35 cities were interviewed. Descriptive analysis and multinomial logistic regression analysis were employed to analyze characteristics of CHS users, frequency of CHS utilization, and the socio-demographic and socio-economic factors influencing frequency of CHS utilization. Results: Female and senior CHS clients were more likely to make 3–5 and ≥6 CHS visits (as opposed to 1–2 visits) than male and young clients, respectively. CHS clients with higher education were less frequent users than individuals with primary education or less in 2008 and 2009; in later surveys, CHS clients with higher education were the more frequent users. The association between frequent CHS visits and family income has changed significantly between 2008 and 2011. In 2011, income status did not have a discernible effect on the likelihood of making ≥6 CHS visits, and it only had a slight effect on making 3–5 CHS visits. Conclusion: CHS may play an important role in providing primary health care to meet the demands of vulnerable populations in China. Over time, individuals with higher education are increasingly likely to make frequent CHS visits than individuals with primary school education or below. The gap in frequency of CHS utilization among different economic income groups decreased from 2008 to 2011.

Suggested Citation

  • 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.
    • Handle: RePEc:plo:pone00:0098095
    DOI: 10.1371/journal.pone.0098095
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    References listed on IDEAS

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    1. Dunlop, Sheryl & Coyte, Peter C. & McIsaac, Warren, 2000. "Socio-economic status and the utilisation of physicians' services: results from the Canadian National Population Health Survey," Social Science & Medicine, Elsevier, vol. 51(1), pages 123-133, July.
    2. Karen Eggleston & Li Ling & Meng Qingyue & Magnus Lindelow & Adam Wagstaff, 2008. "Health service delivery in China: a literature review," Health Economics, John Wiley & Sons, Ltd., vol. 17(2), pages 149-165, February.
    3. Habicht, Jarno & Kunst, Anton E., 2005. "Social inequalities in health care services utilisation after eight years of health care reforms: a cross-sectional study of Estonia, 1999," Social Science & Medicine, Elsevier, vol. 60(4), pages 777-787, February.
    4. Yang, Yansui & Yang, Dan, 2009. "Community health service centers in China, not always trusted by the populations they serve?," China Economic Review, Elsevier, vol. 20(4), pages 620-624, December.
    5. Cunningham, Peter J. & Cornelius, Llewellyn J., 1995. "Access to ambulatory care for American Indians and Alaska Natives; the relative importance of personal and community resources," Social Science & Medicine, Elsevier, vol. 40(3), pages 393-407, February.
    6. 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.
    7. Popay, Jennie & Bartley, Mel & Owen, Charlie, 1993. "Gender inequalities in health: Social position, affective disorders and minor physical morbidity," Social Science & Medicine, Elsevier, vol. 36(1), pages 21-32, January.
    8. Cheng, Shou-Hsia & Chiang, Tung-Liang, 1998. "Disparity of medical care utilization among different health insurance schemes in Taiwan," Social Science & Medicine, Elsevier, vol. 47(5), pages 613-620, September.
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    1. Xiaxia Sun & Hongdao Meng & Zhiqiu Ye & Kyaien O Conner & Zhanqi Duan & Danping Liu, 2019. "Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-14, February.

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