Abstract
BackgroundThe health management plays an important role in improving the quality of life of the elderly and relieving the pressure of health resource consumption. This study aims to assess the income-related inequality in utilisation of health management services (HMS) for the elderly and the contribution of the related factors to inequality in rural Henan China.MethodsThe data from 2015 Henan Rural Residents Health Survey with 1403 elderly people as the final sample were used for analysis. The concentration index (CI) was used to measure inequality in HMS utilisation for the elderly (no HMS, health assessment, physical examination, auxiliary examination, and health guidance). The decomposition of CI was adopted to explain the contribution of various determinants to inequality in HMS utilisation for the elderly.ResultsNo HMS utilisation was disproportionately concentrated among the poor (CI = − 0.0730, p = 0.0155), utilisation of physical and auxiliary examination was disproportionately concentrated among the rich (CI = 0.0575, p = 0.0448; CI = 0.0811, p = 0.0044). In addition, the pro-poor effects of health assessment and guidance utilisation were not statistically significant (CI = − 0.0173, p = 0.4617; CI = − 0.0213, p = 0.3900). The results of CI decomposition revealed that household income and family size made positive contributions to inequality while social medical insurance, gender, marital status, and age made negative contributions to inequality. The improved service satisfaction with village clinics could reduce inequality in HMS utilisation, while the improved service satisfaction with township hospitals could increase inequality in HMS utilisation.ConclusionsAlthough HMS for the elderly is provided free of charge, its accessibility remains pro-rich due to various factors. Policy makers should adopt effective interventions to resolve the contradiction between these factors and the utilisation of HMS, and redress inequality in the utilisation of HMS.
Highlights
The health management plays an important role in improving the quality of life of the elderly and relieving the pressure of health resource consumption
Health management services (HMS) for the elderly include four components [11]: (I) health assessment conducted by evaluating the basic health level, self-care ability, lifestyle, past disease history, and common symptoms and treatment of chronic diseases through enquiring the elderly; (II) physical examinations, including measurement of body temperature, pulse, blood pressure, height, and weight; routine examination of skin, superficial lymph nodes, the heart, lungs, and abdomen; and rough judgment of vision, hearing, and exercise; (III) auxiliary examinations, including blood routine, urine routine, fasting blood glucose, blood lipid, liver function, renal function, and electrocardiogram detection; and (IV) health guidance provided by health workers to the elderly based on the results of health evaluation
Our study holds the idea that the degree of inequality in utilisation of health management services (HMS) for the elderly is low, but inequality disproportionately favors the rich in rural Henan, China
Summary
The health management plays an important role in improving the quality of life of the elderly and relieving the pressure of health resource consumption. Population aging is closely related to the increased risk of diseases, such as heart disease, stroke, and chronic respiratory disorders. These diseases reduce the quality of life of the elderly and consume a large amount of health resources. Health management services (HMS) for the elderly include four components [11]: (I) health assessment conducted by evaluating the basic health level, self-care ability, lifestyle, past disease history, and common symptoms and treatment of chronic diseases through enquiring the elderly; (II) physical examinations, including measurement of body temperature, pulse, blood pressure, height, and weight; routine examination of skin, superficial lymph nodes, the heart, lungs, and abdomen; and rough judgment of vision, hearing, and exercise; (III) auxiliary examinations, including blood routine, urine routine, fasting blood glucose, blood lipid, liver function (serum glutamic oxaloacetic transaminase, glutamic pyruvate transaminase and total bilirubin), renal function (serum creatinine and blood urea nitrogen), and electrocardiogram detection; and (IV) health guidance provided by health workers to the elderly based on the results of health evaluation. The Chinese government requires primary health care facilities to provide free HMS once a year for people aged 65 years and over
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