Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage
Worldwide countries are recognising the need for and significance of universal health coverage (UHC); however, health inequality continues to persist. This study evaluates the status and equity of residents’ demand for and utilisation of health services and expenditure by considering the three compo...
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doaj-02586cf827fd40ca9200ea7c96a3cb312021-01-13T00:03:44ZengMDPI AGInternational Journal of Environmental Research and Public Health1661-78271660-46012021-01-011859359310.3390/ijerph18020593Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health CoverageJianqiang Xu0Juan Zheng1Lingzhong Xu2Hongtao Wu3School of Management, Xuzhou Medical University, Xuzhou 221004, ChinaSchool of Management, Xuzhou Medical University, Xuzhou 221004, ChinaSchool of Public Health, Shandong University, Jinan 250012, ChinaSchool of Management, Tsinghua University, Beijing 100084, ChinaWorldwide countries are recognising the need for and significance of universal health coverage (UHC); however, health inequality continues to persist. This study evaluates the status and equity of residents’ demand for and utilisation of health services and expenditure by considering the three components of universal health coverage, urban-rural differences, and different income groups. Sample data from China’s Fifth Health Service Survey were analysed and the ‘five levels of income classification’ were used to classify people into income groups. This study used descriptive analysis and concentration index and concentration curve for equity evaluation. Statistically significant differences were found in the demand and utilisation of health services between urban and rural residents. Rural residents’ demand and utilisation of health services decreased with an increase in income and their health expenditure was higher than that of urban residents. Compared with middle- and high-income rural residents, middle- and lower-income rural residents faced higher hospitalisation expenses; and, compared with urban residents, equity in rural residents’ demand and utilisation of health services, and annual health and hospitalisation expenditures, were poorer. Thus, equity of health service utilisation and expenditure for urban and rural residents with different incomes remain problematic, requiring improved access and health policies.https://www.mdpi.com/1660-4601/18/2/593demand for health servicesutilisation of health serviceshealth expenditureequity evaluationurban-rural differencesuniversal health coverage |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jianqiang Xu Juan Zheng Lingzhong Xu Hongtao Wu |
spellingShingle |
Jianqiang Xu Juan Zheng Lingzhong Xu Hongtao Wu Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage International Journal of Environmental Research and Public Health demand for health services utilisation of health services health expenditure equity evaluation urban-rural differences universal health coverage |
author_facet |
Jianqiang Xu Juan Zheng Lingzhong Xu Hongtao Wu |
author_sort |
Jianqiang Xu |
title |
Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage |
title_short |
Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage |
title_full |
Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage |
title_fullStr |
Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage |
title_full_unstemmed |
Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage |
title_sort |
equity of health services utilisation and expenditure among urban and rural residents under universal health coverage |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1661-7827 1660-4601 |
publishDate |
2021-01-01 |
description |
Worldwide countries are recognising the need for and significance of universal health coverage (UHC); however, health inequality continues to persist. This study evaluates the status and equity of residents’ demand for and utilisation of health services and expenditure by considering the three components of universal health coverage, urban-rural differences, and different income groups. Sample data from China’s Fifth Health Service Survey were analysed and the ‘five levels of income classification’ were used to classify people into income groups. This study used descriptive analysis and concentration index and concentration curve for equity evaluation. Statistically significant differences were found in the demand and utilisation of health services between urban and rural residents. Rural residents’ demand and utilisation of health services decreased with an increase in income and their health expenditure was higher than that of urban residents. Compared with middle- and high-income rural residents, middle- and lower-income rural residents faced higher hospitalisation expenses; and, compared with urban residents, equity in rural residents’ demand and utilisation of health services, and annual health and hospitalisation expenditures, were poorer. Thus, equity of health service utilisation and expenditure for urban and rural residents with different incomes remain problematic, requiring improved access and health policies. |
topic |
demand for health services utilisation of health services health expenditure equity evaluation urban-rural differences universal health coverage |
url |
https://www.mdpi.com/1660-4601/18/2/593 |
work_keys_str_mv |
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