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Urban-Rural Inequality of Opportunity in Health Care: Evidence from China

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  • Chao Ma

    (School of Economics and Management, Southeast University, Nanjing 211189, China)

  • Ze Song

    (School of Economics, Nankai University, Tianjin 300071, China)

  • Qingqing Zong

    (School of Public Economics and Administration, Shanghai University of Finance and Economics, Shanghai 200433, China)

Abstract

(1) Background: We aim to measure the urban-rural inequality of opportunity in healthcare in China based on the theory of Equality of Opportunity (EOp). (2) Methods: Following the compensation principle , we establish a decomposition strategy for the fairness gap , which we use for the measurement of the inequality of opportunity in urban-rural healthcare utilization. We then use China Health and Nutrition Survey (CHNS) data from 1997 to 2006 to calculate the fairness gap . (3) Results: Empirical analysis using CHNS data shows that the ratio of the fairness gap to the directly observed average urban-rural difference in healthcare was 1.167 for 1997–2000 and 1.744 for 2004–2006. The average urban-rural difference observed directly from original statistical data may have underestimated the degree of this essential inequity. (4) Conclusions: Our findings suggest that upgrading urban-rural reimbursement ratios may not be sufficient in eliminating the inequality of opportunity in healthcare utilization between urban and rural residents. Within the context of an urban-rural dualistic social structure and widening of the urban-rural income gap, a shift to a pro-disadvantaged policy will be a more effective approach in promoting equality of opportunity in healthcare.

Suggested Citation

  • Chao Ma & Ze Song & Qingqing Zong, 2021. "Urban-Rural Inequality of Opportunity in Health Care: Evidence from China," IJERPH, MDPI, vol. 18(15), pages 1-13, July.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:15:p:7792-:d:599496
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    1. Oaxaca, Ronald, 1973. "Male-Female Wage Differentials in Urban Labor Markets," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 14(3), pages 693-709, October.
    2. Balia, Silvia & Jones, Andrew M., 2008. "Mortality, lifestyle and socio-economic status," Journal of Health Economics, Elsevier, vol. 27(1), pages 1-26, January.
    3. Wagstaff, Adam & Lindelow, Magnus, 2008. "Can insurance increase financial risk?: The curious case of health insurance in China," Journal of Health Economics, Elsevier, vol. 27(4), pages 990-1005, July.
    4. Fleurbaey, Marc & Schokkaert, Erik, 2009. "Unfair inequalities in health and health care," Journal of Health Economics, Elsevier, vol. 28(1), pages 73-90, January.
    5. FLEURBAEY, Marc & SCHOKKAERT, Erik, 2011. "Equity in health and health care," LIDAM Discussion Papers CORE 2011026, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    6. John E. Roemer, 2002. "Equality of opportunity: A progress report," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 19(2), pages 455-471.
    7. Partha Deb & Pravin K. Trivedi, 2006. "Specification and simulated likelihood estimation of a non-normal treatment-outcome model with selection: Application to health care utilization," Econometrics Journal, Royal Economic Society, vol. 9(2), pages 307-331, July.
    8. Jusot, F & Tubeuf, S & Trannoy, T, 2010. "Inequality of Opportunities in Health in Europe: Why So Much Difference Across Countries?," Health, Econometrics and Data Group (HEDG) Working Papers 10/26, HEDG, c/o Department of Economics, University of York.
    9. repec:dau:papers:123456789/7032 is not listed on IDEAS
    10. Amartya Sen, 2002. "Why health equity?," Health Economics, John Wiley & Sons, Ltd., vol. 11(8), pages 659-666, December.
    11. Wagstaff, Adam & Lindelow, Magnus & Jun, Gao & Ling, Xu & Juncheng, Qian, 2009. "Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme," Journal of Health Economics, Elsevier, vol. 28(1), pages 1-19, January.
    12. Pedro Rosa Dias, 2009. "Inequality of opportunity in health: evidence from a UK cohort study," Health Economics, John Wiley & Sons, Ltd., vol. 18(9), pages 1057-1074, September.
    13. 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 25-46, July.
    14. Pedro Rosa Dias, 2010. "Modelling opportunity in health under partial observability of circumstances," Health Economics, John Wiley & Sons, Ltd., vol. 19(3), pages 252-264, March.
    15. David Roodman, 2009. "Mixed-process models with cmp," DC09 Stata Conference 11, Stata Users Group.
    16. David Roodman, 2009. "Estimating Fully Observed Recursive Mixed-Process Models with cmp," Working Papers 168, Center for Global Development.
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    2. Ao Sun & Lin Chen & Kunimitsu Yoshida & Meng Qu, 2023. "Spatial Patterns and Determinants of Bed and Breakfasts in the All-for-One Tourism Demonstration Area of China: A Perspective on Urban–Rural Differences," Land, MDPI, vol. 12(9), pages 1-21, September.
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