APPARENT DISPARITY BETWEEN RURAL - URBAN HEALTH CARE FACILITIES please write a report on it and get 50 points!
Answers
Answer:
Explanation:
Inequality in health and health care remains a rather challenging issue in China, existing both in rural and urban area, and between rural and urban. This study used nationally representative data to assess inequality in both rural and urban China separately and to identify socioeconomic factors that may contribute to this inequality.
Methods:
This study used 2008 National Health Services Survey data. Demographic characteristics, income, health status, medical service utilization, and medical expenses were collected. Horizontal inequality analysis was performed using nonlinear regression method.
Results:
Positive inequity in outpatient services and inpatient service was evident in both rural and urban area of China. Greater inequity of outpatient service use in urban than that in rural areas was evident (horizontal inequity index [HI] = 0.085 vs 0.029). In contrast, rural areas had greater inequity of inpatient service use compared to urban areas (HI = 0.21 vs 0.16). The decomposition analysis found that the household income made the greatest pro-rich contribution in both rural and urban China. However, chronic diseases and aging were also important contributors to the inequality in rural area.
Conclusion:
The inequality in health service in both rural and urban China was mainly attributed to the household income. In addition, chronic disease and aging were associated with inequality in rural population. Those findings provide evidences for policymaker to develop a sustainable social welfare system in China.
Keywords: concentration index, decomposition analysis, horizontal inequality analysis, inequality, NHSS
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1. Introduction
Most governments in the world have acknowledged the importance of equality in health and health care, so does the Chinese government. Over the past 4 decades, China has achieved significant improvement in health care system and health outcomes along with its dramatic economic growth. The life expectancy at birth has reached 74.8 years in 2010 compared to 67.9 years in 1981.[1] However, large disparities still exist in both health and health service utilization within and between urban and rural residents due to the lower-income, fewer health resources, and less access to health insurance for the rural population. In 2000 to 2004, the mortality rate of children younger than 5 years was 6.4% in poor rural areas, which was more than 5 times higher than that in the most affluent large cities (1%).[2] Liu found that rural residents used more physicians than urban residents did (52.0% vs 43.0%, P < .001), but used hospitals less (7.6% vs 11.1%, P < .001).[3]
The urban-focused economic reform that started in 1978 has led to an unbalanced growth of economy between urban and rural areas. The development of infrastructure, including transportation, communication, health care, and education system in urban areas were far ahead of that in rural China. This widened the income gap between urban and rural population that has been existing since 1958. The household registration system under the planned economy divided Chinese citizens into urban and rural household.[4] In 2008, annual income per capita for rural residents was RMB ¥6, 700.7 (US$ 1 = ¥6.62), only 40% of that for urban residents (17,067.8 RMB Yuan).[5] Meanwhile, the average consumption expenditure in urban areas has reached 11,242.85 RMB Yuan while in rural areas it is 3660.68 RMB Yuan.[6] The lower-income makes rural residences experience more financial hardship when seeking for health service than their urban counterparts.