Henderson G, Akin J, Zhiming L, Jin S, Ma H, Ge K
University of North Carolina at Chapel Hill 27599.
Soc Sci Med. 1994 Sep;39(5):687-99. doi: 10.1016/0277-9536(94)90024-8.
This paper investigates equity with respect to one component of welfare in China--the provision and use of health services. Based upon a large-scale survey of almost 16,000 individuals in eight provinces in China, we examine a sub-sample of working-age adults who have identified themselves as injured or ill during the four weeks prior to being interviewed. We found that, beyond the level of severity of the reported condition, very few individual-level factors are related to the use of services when ill or injured. Only gender (female) and employment in state-run enterprises are associated with higher patterns of use. These results suggest that China has achieved a very wide distribution of clinics and other services at the local level, and that they are widely used by those who identify need for them. It is rare to be over half an hour away by bike from some form of care and the majority of care appears to be reasonably inexpensive. This broad availability of services contrasts with recent reports from China stressing declining accessibility, and paints a picture of relatively equal access to health care.
本文考察了中国福利的一个组成部分——卫生服务的提供与使用方面的公平性。基于对中国八个省份近16000人的大规模调查，我们研究了一个工作年龄成年人的子样本，这些人在接受访谈前四周内自称受伤或患病。我们发现，除了所报告病情的严重程度外，很少有个体层面的因素与生病或受伤时的服务使用相关。只有性别（女性）和国营企业就业与较高的服务使用模式相关。这些结果表明，中国在地方层面实现了诊所和其他服务的广泛分布，而且那些有需求的人广泛使用这些服务。骑自行车半小时以上路程找不到某种形式医疗服务的情况很少见，而且大多数医疗服务似乎价格合理。服务的广泛可及性与中国近期强调可及性下降的报告形成对比，描绘了一幅相对平等的医疗保健可及性图景。
