Yuan Bocong, Li Jiannan, Wang Zhaoguo, Wu Lily
Faculty of Economics and Management, Sun Yat-sen University, West Xingang Rd. 135, Guangzhou 510275, China.
Healthcare (Basel). 2019 Apr 11;7(2):61. doi: 10.3390/healthcare7020061.
This study investigates the influence of the household registration system on rural-urban disparity in healthcare access (including healthcare quality, blood pressure check, blood test, vision test, dental examination, and breast exam), using data from a large-scale nationwide life history survey that covered 150 counties across 28 provinces and municipalities in China. In contrast to the findings of many previous studies that emphasize the disparity in the residence place as the cause of rural-urban disparity in healthcare access, this study finds that the residence place just has a very limited influence on healthcare access in China, and what really matters is the household registration type. Our empirical results show that people with a non-rural household registration type generally have better healthcare access than those with a rural one. For rural residents, changing the registration type of their household (from rural to non-rural) can improve their healthcare access, whereas changing the residence place or migrating from rural to urban areas have no effect. Therefore, mere rural-to-urban migration may not be a valid measure to eliminate the rural-urban disparity in healthcare access, unless the institution of healthcare resource allocation is reformed.
本研究利用一项大规模全国生活史调查的数据，调查户籍制度对城乡医疗服务可及性差异（包括医疗质量、血压检查、血液检查、视力检查、牙科检查和乳房检查）的影响。该调查覆盖了中国28个省、直辖市的150个县。与许多以往强调居住地点差异是城乡医疗服务可及性差异原因的研究结果不同，本研究发现居住地点在中国对医疗服务可及性的影响非常有限，真正重要的是户籍类型。我们的实证结果表明，非农村户籍类型的人通常比农村户籍类型的人有更好的医疗服务可及性。对于农村居民来说，改变其家庭的户籍类型（从农村变为非农村）可以改善他们的医疗服务可及性，而改变居住地点或从农村迁移到城市地区则没有效果。因此，单纯的农村向城市迁移可能不是消除城乡医疗服务可及性差异的有效措施，除非改革医疗资源分配制度。
