Private Healthcare Expenditure in China: A Regional Comparative Analysis.

Shangguang Yang,Xi Yang,Danyang Wang,Kevin Lo,Lu Xu,Chunlan Wang

doi:10.3390/healthcare9101374

Abstract

Private (out-of-pocket) healthcare expenditure (PHCE) is a complex phenomenon that is shaped by many different factors. In this paper, we analyzed the influencing factors of PHCE in China, with a specific focus on regional differences. We found that old-age dependency ratio, income, and education have significant impacts on PHCE in all regions, whereas public HCE, number of beds in medical institutions, and economic development levels have significant impacts only in some regions. The results indicate that the government should pay attention to regional inequality and implement targeted adjustments for improving the health service system. In particular, we recommend: (1) monitoring regional inequality in PHCE and other healthcare issues to unmask geographical differences in healthcare interventions; (2) adopting regional-specific policy measures—the government should divert some resources from eastern to western and central regions to increasing the support for public health undertakings and improve the quality of the local health services while providing matching medical resources by targeting the needs of the residents; (3) paying more attention to the healthcare demand of the elderly population; and (4) improving the education level of residents to improve public health and avoid high PHCE.

Highlights

Understanding private healthcare expenditure (PHCE) is essential for policymakers in order to identify problems associated with the accessibility and affordability of healthcare [1]
While China has seen rapid economic growth over the past two decades, such development has contributed to regional inequality—the eastern coastal region has the highest level of economic development, followed by the central and western regions [4,5]
In the central and western regions, public HCE has not been shown to exert a significant impact, suggesting a lack of public investment in health care in these areas. These findings show that the regional differences in PHCE in China are associated with regional inequality in socioeconomic development and the quality and availability of healthcare services

Summary

Introduction

Understanding private healthcare expenditure (PHCE) is essential for policymakers in order to identify problems associated with the accessibility and affordability of healthcare [1]. These problems, if not handled properly, may become a threat to economic development, social cohesion, and political stability [2]. While China has seen rapid economic growth over the past two decades, such development has contributed to regional inequality—the eastern coastal region has the highest level of economic development, followed by the central and western regions [4,5]. The inequalities of healthcare resources is worsening in recent decades [13]

Methods

Results

Discussion

Conclusion