School of Economics, Shanghai University of Finance and Economics, 777 Guoding Rd., Yangpu District, Shanghai, China.
School of Public Administration and Policy, Renmin University of China, 59 Zhongguancun Street, Haidian District, Beijing, China.
Soc Sci Med. 2023 Sep;333:116148. doi: 10.1016/j.socscimed.2023.116148. Epub 2023 Aug 5.
China initiated the equalisation of an essential public health service programme in 2009 with the goal of developing a more equitable and effective public health system for all people. This study employs data from the China Migrants Dynamic Survey to examine regional-level and household-level income-related inequalities in public health service utilisation and its determinants. Wagstaff concentration indices indicate that essential public health services and family doctor contract services are concentrated among less developed prefectures and poorer households. Decomposition analysis based on recentered influence function regression shows that education contributes to pro-poor inequality in health records and health education utilisation. China's policies of essential public health services and family doctor contract services reduce income-related inequalities in health service utilisation, which has important implications for developing countries striving to achieve universal health service coverage and equal health outcomes.
中国于 2009 年启动了基本公共卫生服务均等化项目，旨在为全民建立更加公平、有效的公共卫生体系。本研究利用中国流动人口动态监测调查数据，考察了公共卫生服务利用及其决定因素在区域和家庭收入相关不平等方面的情况。 Wagstaff 集中指数表明，基本公共卫生服务和家庭医生签约服务主要集中在欠发达的州和较贫困的家庭。基于重新中心化影响函数回归的分解分析表明，教育有助于改善健康记录和健康教育利用方面的有利于穷人的不平等。中国的基本公共卫生服务和家庭医生签约服务政策减少了卫生服务利用方面的收入相关不平等，这对努力实现全民健康服务覆盖和均等健康结果的发展中国家具有重要意义。
