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Industrialisation et Inégalités : Le recours aux soins en zones rurales chinoises

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  • Carine Milcent

    (EEP-PSE - Ecole d'Économie de Paris - Paris School of Economics - Ecole d'Économie de Paris, PSE - Paris-Jourdan Sciences Economiques - CNRS : UMR8545 - École des Hautes Études en Sciences Sociales (EHESS) - École des Ponts ParisTech (ENPC) - École normale supérieure [ENS] - Paris - Institut national de la recherche agronomique (INRA), CEPREMAP - Centre pour la recherche économique et ses applications - Centre pour la recherche économique et ses applications)

Abstract

Alors que de nombreux travaux ont été effectués à propos de l'effet de l'assurance santé sur la demande de soins, l'effet de l'urbanisation, du processus d'industrialisation et les changements de l'offre de soins n'ont reçu jusqu'ici que peu d'attention. Les données mobilisées proviennent du China Health and Nutrition Survey (CHNS) couvrant la période 1991-2006. Avec le processus d'industrialisation, le nombre d'habitants des zones rurales ayant une activité agricole se réduit. Les zones rurales en voie d'urbanisation développent en priorité les systèmes de transport. L'offre de soins, sous l'impulsion de l'état central et provincial s'est modifiée. Les soins offerts sont de meilleure qualité, l'infrastructure publique s'est concentrée et est mieux équipée et une infrastructure privée et de proximité s'est développée. Par ailleurs, le financement public des établissements publics s'est fortement réduit et les établissements ont utilisé les médicaments et les actes de diagnostic comme générateur de profit. Au final, les habitants des zones rurales travaillant à l'extérieur et ayant un revenu conséquent ont accès à des soins de meilleure qualité qu'avant les réformes économiques. En revanche, les fermiers ayant un faible revenu et peu de mobilité ont vu leur situation se dégrader.

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Paper provided by HAL in its series PSE Working Papers with number halshs-00826889.

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Date of creation: 28 May 2013
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Handle: RePEc:hal:psewpa:halshs-00826889

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Keywords: Industrialisation ; Recours aux soins ; Chine rurale;

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  1. Lucas, Robert Jr., 1988. "On the mechanics of economic development," Journal of Monetary Economics, Elsevier, Elsevier, vol. 22(1), pages 3-42, July.
  2. Wagstaff, Adam & Lindelow, Magnus & Gao Jun & Xu Ling & Qian Juncheng, 2007. "Extending health insurance to the rural population : an impact evaluation of China's new cooperative medical scheme," Policy Research Working Paper Series 4150, The World Bank.
  3. Lindelow, Magnus & Wagstaff, Adam, 2005. "Health shocks in China : are the poor and uninsured less protected ?," Policy Research Working Paper Series 3740, The World Bank.
  4. Bloom, Gerald & Xingyuan, Gu, 1997. "Health sector reform: Lessons from China," Social Science & Medicine, Elsevier, Elsevier, vol. 45(3), pages 351-360, August.
  5. Carine Milcent, 2010. "Healthcare access for migrants in China : A new frontier," PSE Working Papers halshs-00575014, HAL.
  6. Xiaoyan Lei & Wanchuan Lin, 2009. "The New Cooperative Medical Scheme in rural China: does more coverage mean more service and better health?," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages S25-S46, July.
  7. Gordon G. Liu & Xiaodong Wu & Chaoyang Peng & Alex Z. Fu, 2003. "Urbanization And Health Care In Rural China," Contemporary Economic Policy, Western Economic Association International, vol. 21(1), pages 11-24, 01.
  8. Feldstein, Martin S, 1970. "The Rising Price of Physicians' Services," The Review of Economics and Statistics, MIT Press, vol. 52(2), pages 121-33, May.
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