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Which Households Are Most Distant from Health Centers in Rural China? Evidence from a GIS Network Analysis

Author

Listed:
  • John Gibson

    (University of Waikato)

  • Xiangzheng Deng

    (Chinese Academy of Sciences)

  • Geua Boe-Gibson

    (University of Waikato)

  • Scott Rozelle
  • Jikun Huang

Abstract

In this paper we have two objectives - one empirical; one methodological. Although China’s leaders are beginning to pay attention to health care in rural China, there are still concerns about access to health services. To examine this issue, we use measures of travel distances to health services to examine the nature of coverage in Shaanxi Province, our case study. The mean distance by road to the nearest health center is still more than 6 kilometers. When we use thresholds for access of 5 and 10 kilometers we find that more than 40 (15) percent of the rural population lives outside of these 5 (10) kilometer service areas for health centers. The nature of the access differs by geographical region and demographic composition of the household. The methodological contribution of our paper originates from a key feature of our analysis in which we use Geographic Information System (GIS) network analysis methods to measure traveling distance along the road network. We compare these measures to straight-line distance measures. Road distances (produced by network analysis) produce measures (using means) that are nearly twice as great as straight-line distances. Moreover, the errors in the measures (that is, the difference between road distances and straight-line distances) are not random. Therefore, traditional econometric methods of ameliorating the effects of measurement errors, such as instrument variables regression, will not produce consistent results when used with straight-line distances.

Suggested Citation

  • John Gibson & Xiangzheng Deng & Geua Boe-Gibson & Scott Rozelle & Jikun Huang, 2008. "Which Households Are Most Distant from Health Centers in Rural China? Evidence from a GIS Network Analysis," Working Papers in Economics 08/19, University of Waikato.
  • Handle: RePEc:wai:econwp:08/19
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    File URL: https://repec.its.waikato.ac.nz/wai/econwp/0819.pdf
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    References listed on IDEAS

    as
    1. John Gibson & David McKenzie, 2007. "Using Global Positioning Systems in Household Surveys for Better Economics and Better Policy," The World Bank Research Observer, World Bank Group, vol. 22(2), pages 217-241, September.
    2. 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, January.
    3. Liu, Yuanli & Hsiao, William C. & Eggleston, Karen, 1999. "Equity in health and health care: the Chinese experience," Social Science & Medicine, Elsevier, vol. 49(10), pages 1349-1356, November.
    4. Javier Escobal & Sonia Laszlo, 2008. "Measurement Error in Access to Markets," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 70(2), pages 209-243, April.
    5. Barbara Entwisle & Albert Hermalin & Peerasit Kamnuansilpa & Apichat Chamratrithirong, 1984. "A multilevel model of family planning availability and contraceptive use in rural Thailand," Demography, Springer;Population Association of America (PAA), vol. 21(4), pages 559-574, November.
    6. Rosero-Bixby, Luis, 2004. "Spatial access to health care in Costa Rica and its equity: a GIS-based study," Social Science & Medicine, Elsevier, vol. 58(7), pages 1271-1284, April.
    7. Ravallion, Martin & Chen, Shaohua, 2007. "China's (uneven) progress against poverty," Journal of Development Economics, Elsevier, vol. 82(1), pages 1-42, January.
    8. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    9. John Gibson & David McKenzie, 2007. "Using Global Positioning Systems in Household Surveys for Better Economics and Better Policy," The World Bank Research Observer, World Bank Group, vol. 22(2), pages 217-241, September.
    10. Perry, Baker & Gesler, Wil, 2000. "Physical access to primary health care in Andean Bolivia," Social Science & Medicine, Elsevier, vol. 50(9), pages 1177-1188, May.
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    Cited by:

    1. Gerson Javier Pérez V., 2013. "Accesibilidad geográfica y equidad en la prestación del servicio de salud: un estudio de caso para Barranquilla," BORRADORES DE ECONOMIA 010853, BANCO DE LA REPÚBLICA.

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    More about this item

    Keywords

    health access; measurement error; network analysis;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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