Henderson G E, Akin J S, Hutchinson P M, Jin S G, Wang J M, Dietrich J, Mao L M
Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, 27599-7240, USA.
Soc Sci Med. 1998 Dec;47(12):1957-71. doi: 10.1016/s0277-9536(98)00337-2.
Continued pursuit of market-oriented reforms in China seems to have resulted in increasing income disparities. This has raised concerns about possible declines in the use of health services by the poor. Using data from three waves of the China Health and Nutrition Survey (1989, 1991, 1993), we examine whether people age 20-45 in eight provinces became less likely to seek care when ill. We carried out three probit estimations of seeking care when ill; the predictor variables include individual and workplace characteristics, a measure of the severity of illness and community level factors. Health care is broadly defined to include basic level clinics as well as urban hospitals. We find no evidence that health care utilization is decreasing. Rather, for people in a community survey reporting mainly mild or moderate illness, health care continues to be accessible. We consider possible limits of our study and discuss extensively the implications of the use of illness reports from the three cross-sectional surveys as health status indicators.
中国持续推进的市场化改革似乎导致了收入差距的不断扩大。这引发了人们对贫困人口医疗服务利用可能下降的担忧。利用中国健康与营养调查（1989年、1991年、1993年）三轮调查的数据，我们研究了八个省份20至45岁的人群在生病时寻求治疗的可能性是否降低。我们对生病时寻求治疗进行了三次概率估计；预测变量包括个人和工作场所特征、疾病严重程度的衡量指标以及社区层面的因素。医疗保健被广泛定义为包括基层诊所和城市医院。我们没有发现医疗服务利用正在下降的证据。相反，对于社区调查中报告主要为轻度或中度疾病的人群来说，医疗服务仍然是可及的。我们考虑了研究可能存在的局限性，并广泛讨论了将三次横断面调查中的疾病报告用作健康状况指标的影响。
