Abstract
BackgroundEnsuring equal access to preventive care has always been given a priority in health system throughout world. This study aimed to decompose inequality in utilization of preventive care services into its contributing factors and then explore its changes over the period of China’s 2009–2015 health system reform.MethodsThe concentration index (CI) and decomposition of the CI was performed to capture income-related inequalities in preventive services utilization and identify contribution of various determinants to such inequality using data from China Health and Nutrition Survey. Then, changes in inequality from 2009 to 2015 were estimated using Oaxaca-type decomposition technique.ResultsThe CI for preventive services utilization dropped from 0.2240 in 2009 to 0.1825 in 2015. Residential location and household income made the biggest contributions to income-related inequalities in these two years. Oaxaca decomposition revealed changes in residential location, regions and medical insurance made positive contributions to decline in inequality. However, alternation in household income, age and medical services utilization pushed the equality toward deterioration.ConclusionThe pro-rich inequality in preventive healthcare services usage is evident in China despite a certain decline in such inequality during observation period. Policy actions on eliminating urban-rural and income disparity should be given the priority to equalize preventive healthcare.
Highlights
Preventive healthcare is widely recognized as the most cost-effective services as it helps find and address health issues before people have any symptoms [1, 2]
The present study aims to answer the following two questions: 1) Have inequality in utilization of preventive care services changed during the reform of China’s health care system? 2) What were the associated factors contributing to such change?
Data In order to examine the change in inequality in preventive care usage over period of China’s health system reform, the data sets used in this study were from China Health and Nutrition Survey (CHNS) 2009 and 2015
Summary
Preventive healthcare is widely recognized as the most cost-effective services as it helps find and address health issues before people have any symptoms [1, 2]. Empirical evidences from previous studies revealed inputs to preventive health services can reduce treatment costs and save rescue costs. WHO has identified the equal access to prevention as a public health priority in the “Health for All” Agenda [6]. Ensuring even distribution of preventive care is an important task to realize Sustainable Development Goal “promote well-being for all at all ages” announced by United Nations. Ensuring equal access to preventive care has always been given a priority in health system throughout world. This study aimed to decompose inequality in utilization of preventive care services into its contributing factors and explore its changes over the period of China’s 2009–2015 health system reform
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