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. 2017 Jul 26;14(8):842.
doi: 10.3390/ijerph14080842.

Horizontal Inequity in Health Care Utilization among the Middle-Aged and Elderly in China

Chaofan Li  1 , Lei Dou  2 , Haipeng Wang  3 , Shanshan Jing  4 , Aitian Yin  5
Affiliations

Horizontal Inequity in Health Care Utilization among the Middle-Aged and Elderly in China

Chaofan Li et al. Int J Environ Res Public Health. .

Abstract

Background: Equitable utilization of health care is a primary goal of the Chinese health system. This study aimed to examine horizontal inequity in health care utilization and identify the factors resulting in inequity among the middle-aged and elderly in China.

Methods: The data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). We employed the concentration index (CI) and horizontal inequity (HI) to measure inequity in health care utilization. Non-linear regression models were used to decompose the CI into the contribution of each factor.

Results: The CIs for the probability of and total number of outpatient visits were 0.0642 and 0.0780, respectively, and those for inpatient visits were 0.1418 and 0.1471, respectively. The HIs were also significantly positive. Living standard was the most important contributor. The contribution of health insurance varied between plans.

Conclusions: This study supported the presence of pro-rich inequity in health care utilization for both probability and frequency among the middle-aged and elderly in China. Narrowing the living standard gap and improving the health insurance benefit package for the elderly should help to resolve these inequities.

Keywords: China; health care utilization; horizontal inequity; middle-aged and elderly.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Decomposition of inequalities in health care utilization.
See this image and copyright information in PMC

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