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Performance and Sociodemographic Determinants of Excess Outpatient Demand of Rural Residents in China: A Cross-Sectional Study

Author

Listed:
  • Yanchen Liu

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, China)

  • Yingchun Chen

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, China)

  • Xueyan Cheng

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, China)

  • Yan Zhang

    (School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
    Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan 430030, China)

Abstract

Excess healthcare utilization is rapidly rising in rural China. This study focused on excess outpatient demand (EOD) and aimed to measure its performance and sociodemographic determinants among China’s rural residents. A total of 1290 residents from four counties in central China were enrolled via multistage cluster random sampling. EOD is the condition in which the level of hospital a patient chooses is higher than the indicated level in the governmental guide. A multilevel logistic regression was used to examine the sociodemographic determinants of EOD. Residents with EOD accounted for 85.83%. The risk of EOD was 51.17% and value was 5.69. The value of EOD in diseases was higher than that in symptoms (t = −21.498, p < 0.001). Age (OR = 0.489), educational level (OR = 1.986) and hospital distance difference (OR = 0.259) were the main sociodemographic determinants of EOD. Excess outpatient demand was evident in rural China, but extreme conditions were rare. Results revealed that age, educational level and hospital distance were the main sociodemographic determinants of EOD. The capacity of primary healthcare institutions, universality of common disease judgement and understanding of institution’s scope of disease curing capabilities of residents should be improved to reduce EOD.

Suggested Citation

  • Yanchen Liu & Yingchun Chen & Xueyan Cheng & Yan Zhang, 2020. "Performance and Sociodemographic Determinants of Excess Outpatient Demand of Rural Residents in China: A Cross-Sectional Study," IJERPH, MDPI, vol. 17(16), pages 1-14, August.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:16:p:5963-:d:400078
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    1. Zhang, Xuanchuan & Chen, Li-Wu & Mueller, Keith & Yu, Qiao & Liu, Jiapeng & Lin, Ge, 2011. "Tracking the effectiveness of health care reform in China: A case study of community health centers in a district of Beijing," Health Policy, Elsevier, vol. 100(2-3), pages 181-188, May.
    2. Dourgnon, Paul & Naiditch, Michel, 2010. "The preferred doctor scheme: A political reading of a French experiment of Gate-keeping," Health Policy, Elsevier, vol. 94(2), pages 129-134, February.
    3. Groenewegen, Peter P. & Dourgnon, Paul & Greß, Stefan & Jurgutis, Arnoldas & Willems, Sara, 2013. "Strengthening weak primary care systems: Steps towards stronger primary care in selected Western and Eastern European countries," Health Policy, Elsevier, vol. 113(1), pages 170-179.
    4. Xiaxia Sun & Hongdao Meng & Zhiqiu Ye & Kyaien O Conner & Zhanqi Duan & Danping Liu, 2019. "Factors associated with the choice of primary care facilities for initial treatment among rural and urban residents in Southwestern China," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-14, February.
    5. Wenwei Liu & Suwei Yuan & Fengqin Wei & Jing Yang & Jin Ma, 2018. "Inappropriate admissions of the cardiology and orthopedics departments of a tertiary hospital in Shanghai, China," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-12, December.
    6. Agnus M. Kim & Seongcheol Cho & Hyun Joo Kim & Hyemin Jung & Min-Woo Jo & Jin Yong Lee & Sang Jun Eun, 2018. "Primary Care Patients’ Preference for Hospitals over Clinics in Korea," IJERPH, MDPI, vol. 15(6), pages 1-11, May.
    7. Rao, Krishna D. & Sheffel, Ashley, 2018. "Quality of clinical care and bypassing of primary health centers in India," Social Science & Medicine, Elsevier, vol. 207(C), pages 80-88.
    8. Zhang, Xuanchuan & Chen, Li-Wu & Mueller, Keith & Yu, Qiao & Liu, Jiapeng & Lin, Ge, 2011. "Tracking the effectiveness of health care reform in China: A case study of community health centers in a district of Beijing," Health Policy, Elsevier, vol. 100(2), pages 181-188.
    9. McClain, J.O. & Riedel, D.C., 1973. "Screening for utilization review: on the use of explicit criteria and non-physicians in case selection," American Journal of Public Health, American Public Health Association, vol. 63(3), pages 247-251.
    10. repec:dau:papers:123456789/12227 is not listed on IDEAS
    11. Philip H. Brown & Caroline Theoharides, 2009. "Health‐seeking behavior and hospital choice in China's New Cooperative Medical System," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 47-64, July.
    12. Suhang Song & Beibei Yuan & Luyu Zhang & Gang Cheng & Weiming Zhu & Zhiyuan Hou & Li He & Xiaochen Ma & Qingyue Meng, 2018. "Increased Inequalities in Health Resource and Access to Health Care in Rural China," IJERPH, MDPI, vol. 16(1), pages 1-10, December.
    13. repec:dau:papers:123456789/12226 is not listed on IDEAS
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