School of Social Development and Public Policy, Beijing Normal University, Beijing 100875, China.
Health Policy. 2009 Dec;93(2-3):111-7. doi: 10.1016/j.healthpol.2009.06.003. Epub 2009 Jul 17.
The purpose of this study was to examine inequalities of access to health care among the urban elderly in northwestern China.
4441 seniors (over 60 years of age) were drawn from a cross-sectional study conducted in three northwestern Chinese cities. The effects of these factors on the use of health care services (visits to physician and hospitalizations) were estimated using multiple binomial regressions.
Overall, 7.6% of the population studied had visited a physician during the past 4 weeks, 10.1% had used inpatient care during the past year, and 7.6% did not use inpatient services despite being referred by doctors for hospital admission during the previous year. Both visits to a physician and non-hospitalization were independently associated with the place of residence and household per capita income; the use of inpatient care services was significantly lower among those with less education, those with lower household per capita income and those without health insurance coverage. Women tended to make more use of outpatient services, but spent less time and money in hospital than men.
Our findings indicate a significant inequality of access to health care services among urban seniors in northwestern China. More appropriate health care policies should be developed to achieve the goal of greater equality of access to health care services for all.
本研究旨在考察中国西北地区城市老年人的医疗保健服务获取不平等情况。
本研究采用横断面研究方法，从中国西北三个城市抽取了 4441 名老年人（60 岁以上）。使用多项二项式回归估计这些因素对卫生保健服务使用（就诊和住院）的影响。
总体而言，在过去的 4 周内，有 7.6%的研究人群看过医生，在过去的一年中，有 10.1%的人使用过住院治疗，而在过去的一年中，有 7.6%的人尽管被医生推荐住院治疗，但没有使用住院服务。就诊和非住院治疗均与居住地和家庭人均收入独立相关；受教育程度较低、家庭人均收入较低和没有医疗保险的人使用住院服务的比例明显较低。女性倾向于更多地使用门诊服务，但在医院的时间和花费比男性少。
我们的研究结果表明，中国西北地区城市老年人的医疗保健服务获取存在显著的不平等。应制定更适当的医疗保健政策，以实现全民更公平地获得医疗保健服务的目标。
