Subnational analysis of healthcare access and quality in China during 1990−2015

Abstract

The healthcare access and quality (HAQ) is an important index that reflects health system capacity for timely and effectively detecting, managing, curing and avoiding death from a range of diseases. The purpose of this study is to examine the current status and temporal trend of the healthcare access and quality in China at both national and provincial level. Using the results of global burden of disease study 2015, we compared the HAQ index between China and some other selected countries, at the same time analyzed the differences in HAQ and its temporal trend from 1990 to 2015 both by diseases and by provinces across China. In 2015, the HAQ index of China was 74.2, and 20.5 higher than the global average; the HAQ index was only 1.2 lower than its expectancy in China and this gap was far lower than the global average (20.1). From 1990 to 2015, in China, the HAQ was higher in respiratory diseases (upper respiratory infections, chronic respiratory disease), vaccine-preventable diseases (Diphtheria, Whooping cough, Tetanus, Measles), diseases for which routine surgeries can easily avert mortality (appendicitis,inguinal, femoral, and abdominal hernia), maternal disorders, Ischaemic heart disease, and adverse effects of medical treatment. In 2015, there were 9 provinces, such as Beijing, Macao, Shanghai and so on, with a HAQ index of 80 or more, whilst the lowest HAQ index was found in Tibet, Qinghai, Guizhou, Xinjiang and Yunnan. In most provinces with highest and relatively higher level of socio-demographic development, the HAQ index was higher than its expectancy. From 1990 to 2015, the HAQ index increased by 49.30%, among which the provinces with the largest increasing were Xinjiang, Jiangxi, Yunnan and Shaanxi and their growth rates were more than 55%. The provinces with the smallest increase in HAQ index were Tibet, Hong Kong and Macao. This study indicated that between 1990 and 2015, the healthcare access and quality in China have been improved markedly, but the gaps remained among diseases and among provinces.