Abstract
To explore healthcare disparities in rural China two years after the implementation of the Essential Public Health Service (EPHS) reform in 2009. A cross-sectional study was conducted by surveying 930 hypertension patients (HPs) from different regions in rural China in 2011. The percentages of patients using recommended four or more follow-up visits in a year were calculated by patient socio-demographic characteristics and statistically examined using chi-square and logistic regression to uncover disparities and correlated factors in EPHS use. The rates were not significantly different by age, gender, education, insurance status or income, but significantly different by region and hypertension history (p<0.01). Higher rates were also observed on patients who sought actively follow-up service at clinics, making appointment for the next follow-up with doctors, awareness of the need of follow-up, more satisfied with the follow-up services, and better medication adherence (p<0.01). There were no disparities observed among HPs in the use of follow-up services, suggesting that the reform has to some extent achieved its goal in ensuring equal access to EPHS. In this regard, regional implementation of the national policies and improvement of EPHS management at local level should be further improved.
Highlights
Sweeping economic reforms in China over the past three decades have brought about unprecedented economic prosperity
Socio-demographic characteristics: Table-I presents the demographic characteristics of the participants, who were mostly aged 65 or above, with education below middle school, with coverage by New Rural Cooperative Medical System (NRCMS) (The universal coverage rate was more than 90%)
hypertension patients (HPs) with different levels of family income. This implies that regardless of the region the patients are located in, poor people and rich people received the same level of Essential Public Health Service (EPHS)
Summary
Sweeping economic reforms in China over the past three decades have brought about unprecedented economic prosperity. They have significantly widened the income and social inequality among Chinese people. The ruralurban divide in health and healthcare is especially evident in the fact that the average life expectancy of urban residents is 73 years, 8 years longer than that of rural residents.. The disparities across rural areas are serious, where infectious diseases, endemic diseases and malnutrition are still prevalent, chronic conditions are on the rise, with many families in poverty or falling into poverty due to illness. Uneven developments in economics and health systems make access to essential health services a greater challenge in some areas and for some families than others.. Uneven developments in economics and health systems make access to essential health services a greater challenge in some areas and for some families than others. Many studies have
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