Abstract
BackgroundThe aim of this study was to assess the trends in equity of receiving inpatient health service utilization (IHSU) in China over the period 2011–2018.MethodsLongitudinal data obtained from China Health and Retirement Longitudinal Studies were used to determine trends in receiving IHSU. Concentration curves, concentration indices, and horizontal inequity indices were applied to evaluate the trends in equity of IHSU.ResultsThis study showed that the annual rate of IHSU gradually increased from 7.99% in 2011 to 18.63% in 2018. Logistic regression shows that the rates of annual IHSU in 2018 were nearly 3 times (OR = 2.86, 95%CL: 2.57, 3.19) higher for rural respondents and 2.5 times (OR = 2.49, 95%CL: 1.99, 3.11) higher for urban respondents than the rates in 2011 after adjusting for other variables. Concentration curves both in urban and rural respondents lay above the line of equality from 2011 to 2018. The concentration index remained negative and increased significantly from − 0.0147 (95% CL: − 0.0506, 0.0211) to − 0.0676 (95% CL: − 0.0894, − 0.458), the adjusted concentration index kept the same tendency. The horizontal inequity index was positive in 2011 but became negative from 2013 to 2018, evidencing a pro-low-economic inequity trend.ConclusionsWe find that the inequity of IHSU for the middle-aged and elderly increased over the past 10 years, becoming more focused on the lower-economic population. Economic status, lifestyle factors were the main contributors to the pro-low-economic inequity. Health policies to allocate resources and services are needed to satisfy the needs of the middle-aged and elderly.
Highlights
The aim of this study was to assess the trends in equity of receiving inpatient health service utilization (IHSU) in China over the period 2011–2018
Middle-aged and elderly population bear a higher burden of chronic diseases, depression, disability and other diseases than young people as they grow older, which leads to a greater demand for medical services, especially inpatient care, it is essential to monitor the changes in IHSU rates
Our study aims to update the information on the trends in annual rates and equity of IHSU among an older segment of the population-the middle-aged and elderly, to quantify personal socioeconomic factors associated with inequalities in IHSU in China, and to provide scientific evidence and recommendations for improving governmental health policies concerning healthcare inequity
Summary
The aim of this study was to assess the trends in equity of receiving inpatient health service utilization (IHSU) in China over the period 2011–2018. In 2013, the National Health Commission increased the rate of reimbursement expense for inpatient health service to around 75% for rural residents. These health policies that favor people at lower income levels have made significant progress in the provision of health services in recent decades by treating affordability as a major barrier to equal access to health services. Middle-aged and elderly population bear a higher burden of chronic diseases, depression, disability and other diseases than young people as they grow older, which leads to a greater demand for medical services, especially inpatient care, it is essential to monitor the changes in IHSU rates
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