ArticleInternational journal for equity in health2023
Changing inequity in health service utilization and financial burden among patients with hypertension in China: evidence from China Health and Retirement Longitudinal Study (CHARLS), 2011-2018.
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 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 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
- Assessing intervention effects on healthcare-related financial protection in low- and middle-income countries: a rapid evidence review.Health policy and planning · 2026Review
- Temporal-spatial analysis and driving factors of coupling coordination between population and health services systems in China, 2010-2022.BMC health services research · 2026Article
- Paid work participation and cognitive function trajectories among older adults in China: evidence from a longitudinal study.BMC geriatrics · 2026Article
- Association between hemoglobin A1c to HDL cholesterol ratio and hypertension in middle-aged and older Chinese adults: a cross-sectional study.BMC cardiovascular disorders · 2026Article
- Effect of continuity of care on medical expenditures for hypertensive patients in high-altitude areas of China.Health policy and planning · 2026Article
- Association between metabolic dysregulation and frailty in four prospective cohorts.Journal of health, population, and nutrition · 2026Article
- Prevalence and management of hypertension among adults aged 45 and older in mainland China: Insights from the 2020 CHARLS survey.Medicine · 2026Article
- A cross-sectional study on associated factors of Chinese herbal medicine use in middle-aged and older adults with dyslipidaemia.Scientific reports · 2026Article
- Dynamic effects of outpatient pooling scheme on socioeconomic inequality in healthcare utilization in China from 2011 to 2020.Scientific reports · 2025Article
- Measuring and decomposing inequalities in intrinsic capacity among older adults in china: from an urban-rural divide perspective.Aging clinical and experimental research · 2025Article
- Burden of low-back pain disease caused by occupational ergonomic factors in China from 1990 to 2021 and forecast for 2035: a systematic analysis and comparison with global trends.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Geographic disparities in hospital readmissions: a retrospective cohort study among patients with chronic disease in rural China.International journal for equity in health · 2025Article
- Association between LDL/HDL ratio and hypertension in Chinese middle-aged and older adults: a cross-sectional and longitudinal analysis based on CHARLS LDL/HDL ration and hypertension.Frontiers in endocrinology · 2025Article
- Utilization of preventative health checkup services in China among middle-aged and older adult population: evidence from China's 28 provinces.Frontiers in public health · 2025Article
- Analysis on equity of health service utilization and influencing factors in patients with hypertension in China: a longitudinal study.BMC health services research · 2024Article
- Gender disparities in physical, psychological, and cognitive multimorbidity among elderly hypertensive populations in rural regions.International journal for equity in health · 2024Article
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5 authors.
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Abstract
backgroundChina initiated a health system reform in 2009 to achieve Universal Health Coverage (UHC) by 2020. While the effectiveness of health-system reforms has been studied, equity in health-service utilization and financial burden remains underexplored. This study evaluated whether the health system reform has improved the equity in utilization and financial burden of health services among patients with hypertension in China.
methodsWe obtained data from four waves of the China Health and Retirement Longitudinal Study (CHARLS) conducted between 2011 and 2018. The main outcome variables were outpatient and inpatient service utilization rates and catastrophic health expenditure (CHE) for patients with hypertension. The Standardized Concentration Index (CI) was used to measure the changing equity in health service utilization and affordability.
resultsOutpatient service utilization was relatively equal among patients with varying socioeconomic statuses (SESs) (CI: 0.041 in 2011 and 0.064 in 2018). Inpatient service utilization inequity improved from CI 0.144 in 2011 to CI 0.066 in 2018. CHE incidence increased from 15.6% in 2011 to 24.2% in 2018. CI for CHE declined from -0.069 in 2011 to -0.012 in 2015 but increased to -0.063 in 2018.
conclusionsHealth insurance expansion and poverty alleviation policies promoted equity in inpatient service utilization for hypertensive patients. However, the financial burden for the poor requires further attention through reimbursement policy adjustments for outpatient services in primary care settings.
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