Abstract
ObjectivesTo comprehend the relationship between various indicators of health service equity and patients’ health expenditure poverty in different regions of China, identify areas where equity in health service is lacking and provide ideas for improving patients’ health expenditure poverty.MethodData from China Family Panel Studies (CFPS) in 2018 and the HFGT index formula were used to calculate the health expenditure poverty index of each province. Moreover, Global Moran’s I and Local Moran’s I test are applied to measure whether there is spatial aggregation of health expenditure poverty. Finally, an elastic net regression model is established to analyze the impact of health service equity on health expenditure poverty, with the breadth of health expenditure poverty as the dependent variable and health service equity as the independent variable.ResultsIn the developed eastern provinces of China, the breadth of health expenditure poverty is relatively low. There is a significant positive spatial agglomeration. “Primary medical and health institutions per 1,000 population”, “rural doctors and health workers per 1,000 population”, “beds in primary medical institutions per 1,000 population”, “proportion of government health expenditure” and “number of times to participate in medical insurance (be aided) per 1,000 population” have a positive impact on health expenditure poverty. “Number of health examinations per capita” and “total health expenditure per capita” have a negative impact on health expenditure poverty. Both effects passed the significance test.ConclusionTo enhance the fairness of health resource allocation in China and to alleviate health expenditure poverty, China should rationally plan the allocation of health resources at the grassroots level, strengthen the implementation of hierarchical diagnosis and treatment and encourage the investment in business medical insurance industry. Meanwhile, it is necessary to increase the intensity of medical assistance and enrich financing methods. All medical expenses of the poorest should be covered by the government.
Highlights
Over the past few decades, the issue of equity in health services has attracted great attention
To enhance the fairness of health resource allocation in China and to alleviate health expenditure poverty, China should rationally plan the allocation of health resources at the grassroots level, strengthen the implementation of hierarchical diagnosis and treatment and encourage the investment in business medical insurance industry
We further explored the spatial correlation of the breadth of health expenditure poverty in different regions of China through the local Moran’s I (Fig. 2), and a significance test was conducted (Table 3)
Summary
Over the past few decades, the issue of equity in health services has attracted great attention. The World Report states that equity is at the heart of primary health care. Health service refers to the general term of social medical treatment, public health activities, facilities and systems. It includes health institutions with sound services for health promotion, disease prevention, treatment and rehabilitation, a complete and quality-assured service network, a certain amount of economic input, fair and reasonable allocation of health resources, and guaranteed service availability [1]. It includes but is not limited to the equity of health care, the equity of health and the equity in the financing of health services [2]
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