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Inequality of access to health care among the urban elderly in northwestern China

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  • Luo, Juhua
  • Zhang, Xiulan
  • Jin, Chenggang
  • Wang, Dongmin
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    Abstract

    Objective The purpose of this study was to examine inequalities of access to health care among the urban elderly in northwestern China.Methods 4441 seniors (over 60 years of age) were drawn from a cross-sectional study conducted in three northwestern Chinese cities. The effects of these factors on the use of health care services (visits to physician and hospitalizations) were estimated using multiple binomial regressions.Results Overall, 7.6% of the population studied had visited a physician during the past 4 weeks, 10.1% had used inpatient care during the past year, and 7.6% did not use inpatient services despite being referred by doctors for hospital admission during the previous year. Both visits to a physician and non-hospitalization were independently associated with the place of residence and household per capita income; the use of inpatient care services was significantly lower among those with less education, those with lower household per capita income and those without health insurance coverage. Women tended to make more use of outpatient services, but spent less time and money in hospital than men.Conclusion Our findings indicate a significant inequality of access to health care services among urban seniors in northwestern China. More appropriate health care policies should be developed to achieve the goal of greater equality of access to health care services for all.

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    Bibliographic Info

    Article provided by Elsevier in its journal Health Policy.

    Volume (Year): 93 (2009)
    Issue (Month): 2-3 (December)
    Pages: 111-117

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    Handle: RePEc:eee:hepoli:v:93:y:2009:i:2-3:p:111-117

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    Web page: http://www.elsevier.com/locate/healthpol

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    Keywords: Elderly health Health care utilization Access to health care Equity;

    References

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    1. Gao, Jun & Raven, Joanna H. & Tang, Shenglan, 2007. "Hospitalisation among the elderly in urban China," Health Policy, Elsevier, vol. 84(2-3), pages 210-219, December.
    2. Yu, Mei-Yu & Sarri, Rosemary, 1997. "Women's health status and gender inequality in China," Social Science & Medicine, Elsevier, vol. 45(12), pages 1885-1898, December.
    3. Goddard, Maria & Smith, Peter, 2001. "Equity of access to health care services: : Theory and evidence from the UK," Social Science & Medicine, Elsevier, vol. 53(9), pages 1149-1162, November.
    4. Liu, Gordon G. & Zhao, Zhongyun & Cai, Renhua & Yamada, Tetsuji & Yamada, Tadashi, 2002. "Equity in health care access to: assessing the urban health insurance reform in China," Social Science & Medicine, Elsevier, vol. 55(10), pages 1779-1794, November.
    5. de Boer, Angela G. E. M. & Wijker, Wouter & de Haes, Hanneke C. J. M., 1997. "Predictors of health care utilization in the chronically ill: a review of the literature," Health Policy, Elsevier, vol. 42(2), pages 101-115, November.
    6. Liu, Yuanli, 2002. "Reforming China's urban health insurance system," Health Policy, Elsevier, vol. 60(2), pages 133-150, May.
    7. Fernandez-Olano, C. & Hidalgo, J.D. Lopez-Torres & Cerda-Diaz, R. & Requena-Gallego, M. & Sanchez-Castano, C. & Urbistondo-Cascales, L. & Otero-Puime, A., 2006. "Factors associated with health care utilization by the elderly in a public health care system," Health Policy, Elsevier, vol. 75(2), pages 131-139, January.
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