Zhang Xin, Wu Qunhong, Shao Yongxiang, Fu Wenqi, Liu Guoxiang, Coyte Peter C
Harbin Medical University, Harbin, China.
Harbin Medical University, Harbin, China
Asia Pac J Public Health. 2015 May;27(4):429-38. doi: 10.1177/1010539514565446. Epub 2015 Jan 5.
The study assessed the present degree of inequity in health care utilization as well as the contributions of the main determinants in the context of expending health insurance coverage in China. Data were obtained from the 2008 National Health Services Survey (NHSS) in China. A concentration index was used to quantify the degree of income-related inequity in health care utilization. The need-standardized concentration indexes of outpatient care and inpatient care were 0.015 and 0.197, respectively. Income made the largest contribution to inequity favoring the better-off in the use of health care. The impacts of health insurance schemes on overall inequity varied according to the insurance memberships as well as types of services. The study revealed a pro-rich distribution of the probability of health care across income groups in China. Increased financial protection ability of medical insurance system remains a vital cornerstone to tackle the health care utilization inequity.
该研究评估了中国在扩大医疗保险覆盖范围背景下医疗服务利用方面当前的不公平程度以及主要决定因素的作用。数据来自2008年中国国家卫生服务调查(NHSS)。使用集中指数来量化医疗服务利用中与收入相关的不公平程度。门诊和住院服务的需求标准化集中指数分别为0.015和0.197。在医疗服务利用方面,收入对有利于富裕群体的不公平现象贡献最大。医疗保险计划对总体不公平的影响因保险参保情况和服务类型而异。该研究揭示了中国不同收入群体在医疗服务概率上存在有利于富人的分布情况。提高医疗保险系统的经济保障能力仍然是解决医疗服务利用不公平问题的关键基石。