中国中老年人健康检查利用公平性的分解分析：基于 2011 年至 2018 年 CHARLS 的纵向数据。

Decomposition analysis on the equity of health examination utilization for the middle-aged and elderly people in China: based on longitudinal CHARLS data from 2011 to 2018.

机构信息

School of Public Administration, Inner Mongolia University, Yuquan District, Zhaojun Road, Hohhot, 010070, Inner Mongolia, China.

School of Public Policy and Administration, Xi'an Jiaotong University, No. 28 Xianning West Road, Xi'an, 710049, Shaanxi, China.

出版信息

BMC Public Health. 2024 Apr 10;24(1):998. doi: 10.1186/s12889-024-18068-x.

DOI:10.1186/s12889-024-18068-x

PMID:38600464

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11312603/

Abstract

BACKGROUND

This study aimed to investigate the utilization rate and equity of health examination service among the middle-aged and elderly population in China from 2011 to 2018. The contribution of various determinants to the inequity in health examination service utilization was also examined.

METHODS

Data from the China Health and Retirement Longitudinal Survey (CHARLS) were analyzed to assess the health examination service utilization rate among the middle-aged and elderly population. A concentration curve and concentration index were employed to measure the equity of health examination service utilization and decomposed into its determining factors. Horizontal inequity index was applied to evaluate the trends in equity of health examination service.

RESULTS

The health examination service utilization rates among the middle-aged and elderly population were 29.45%, 20.69%, 25.40%, and 32.05% in 2011, 2013, 2015, and 2018, respectively. The concentration indexes for health examination service utilization were 0.0080 (95% CI: - 0.0084, 0.0244), 0.0155 (95% CI: - 0.0054, 0.0363), 0.0095 (95% CI: - 0.0088, 0.0277), and - 0.0100 (95% CI: - 0.0254, 0.0054) from 2011 to 2018, respectively. The horizontal inequity index was positive from 2011 to 2018, evidencing a pro-rich inequity trend. Age, residence, education, region, and economic status were the major identified contributors influencing the equity of health examination service utilization.

CONCLUSIONS

A pro-rich inequity existed in health examination service utilization among the middle-aged and elderly population in China. Reducing the wealth and regional gap, providing equal educational opportunities, and strengthening the capacity for chronic disease prevention and control are crucial for reducing the inequity in health examination service utilization.

摘要

背景

本研究旨在调查 2011 年至 2018 年期间中国中老年人健康检查服务的利用率及其公平性。还考察了各种决定因素对健康检查服务利用不公平的贡献。

方法

使用中国健康与退休纵向调查（CHARLS）的数据来评估中老年人的健康检查服务利用率。使用集中曲线和集中指数来衡量健康检查服务利用的公平性，并将其分解为决定因素。应用水平不公平指数评估健康检查服务公平性的趋势。

结果

2011 年、2013 年、2015 年和 2018 年，中老年人健康检查服务利用率分别为 29.45%、20.69%、25.40%和 32.05%。健康检查服务利用的集中指数分别为 0.0080（95%CI：-0.0084，0.0244）、0.0155（95%CI：-0.0054，0.0363）、0.0095（95%CI：-0.0088，0.0277）和-0.0100（95%CI：-0.0254，0.0054）。2011 年至 2018 年，水平不公平指数为正，表明存在贫富不均的趋势。年龄、居住地、教育程度、地区和经济状况是影响健康检查服务利用公平性的主要因素。