ArticleInternational journal for equity in health2023
Horizontal inequity trends of health care utilization in rural China after the medicine and healthcare system reform: based on longitudinal data from 2010 to 2018.
Article in International journal for equity in health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Equitable utilization of non-communicable disease services in low- and middle-income countries; associated factors and intervention effects: a systematic review and meta-analysis.BMC health services research · 2026Pooled it
- The Distribution, Accessibility, and Equity of Primary Care Facilities in China-A Nationwide Analysis Based on POI and High-Resolution Population Data.Healthcare (Basel, Switzerland) · 2026Article
- Regional disparities, dynamic evolution, and convergence of China's resident health service development levels.BMC health services research · 2026Article
- Enrollment or dropout: dynamics of social health insurance participation among Chinese children and their impact on health service utilization and medical expenses.Health policy and planning · 2026Article
- Medication adherence among geriatric patients with chronic diseases in rural China: a social ecological model perspective.BMC geriatrics · 2026Article
- Does the hierarchical medical system enhance healthcare utilization and equity in China? a longitudinal study 2012-2018.BMC public health · 2025Article
- From inequalities to solutions: an explanatory sequential study on type 2 diabetes health services utilization.BMC health services research · 2025Article
- Knowledge, attitudes, and practices of chemotherapy adverse reactions and care among patients with gastrointestinal lymphoma.Frontiers in medicine · 2025Article
- Improving primary healthcare quality in China through training needs analysis.Scientific reports · 2024Article
- Inequity in the utilization of the home and community integrated healthcare and daily care services in older adults with limited mobility in China.BMC geriatrics · 2024Article
- Equity and Prediction of Bed Allocation of the Department of Stomatology in Chinese Hospitals.Risk management and healthcare policy · 2024Article
- Effectiveness of hierarchical medical system and economic growth: based on China's urban vs. rural health perspectives.Frontiers in public health · 2024Article
- Trends in socioeconomic inequality in e-cigarette use among adolescents in South Korea.Tobacco induced diseases · 2024Article
- Inequalities changes in health services utilization among middle-aged and older adult disabled people in China: based on CHARLS 2011-2018.Frontiers in public health · 2024Article
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14 authors.
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Abstract
backgroundTo assess the effectiveness of China's medicine and health care reform in promoting equity in health care utilization among rural residents, it is necessary to analyze temporal trends in equity in health care utilization among rural residents in China. This study is the first to assess horizontal inequity trends in health care utilization among rural Chinese residents from 2010 to 2018 and provides evidence for improving government health policies.
methodsLongitudinal data obtained from China Family Panel Studies from 2010 to 2018 were used to determine trends in outpatient and inpatient utilization. Concentration index, concentration curve, and horizontal inequity index were calculated to measure inequalities. Decomposition analysis was applied to measure the contribution of need and non-need factors to the unfairness.
resultsFrom 2010 to 2018, outpatient utilization among rural residents increased by 35.10%, while inpatient utilization increased by 80.68%. Concentration indices for health care utilization were negative in all years. In 2012, there was an increase in the concentration index for outpatient utilization (CI = -0.0219). The concentration index for inpatient utilization decreased from -0.0478 in 2010 to -0.0888 in 2018. Except for outpatient utilization in 2012 (HI = 0.0214), horizontal inequity indices for outpatient utilization were negative in all years. The horizontal inequity index for inpatient utilization was highest in 2010 (HI = -0.0068) and lowest in 2018 (HI = -0.0303). The contribution of need factors to the inequity exceeded 50% in all years.
conclusionsBetween 2010 and 2018, low-income groups in rural China used more health services. This seemingly pro-poor income-related inequality was due in large part to the greater health care need among low-income groups. Government policies aimed at increasing access to health services, particularly primary health care had helped to make health care utilization in rural China more equitable. It is necessary to design better health policies for disadvantaged groups to reduce future inequities in the use of health services by rural populations.
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