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. 2018 Dec 25;16(1):49.
doi: 10.3390/ijerph16010049.

Increased Inequalities in Health Resource and Access to Health Care in Rural China

Suhang Song  1   2 , Beibei Yuan  3 , Luyu Zhang  4 , Gang Cheng  5 , Weiming Zhu  6 , Zhiyuan Hou  7 , Li He  8 , Xiaochen Ma  9 , Qingyue Meng  10   11
Affiliations

Increased Inequalities in Health Resource and Access to Health Care in Rural China

Suhang Song et al. Int J Environ Res Public Health. .

Abstract

Both health resources and access to these resources increased after China's health care reform launched in 2009. However, it is not clear if the inequalities were reduced within rural China, which was one of the main targets in the reform. This study aims to examine the changes in inequalities in health resources and access following the reform. Data came from the routine report of rural counties in every other year from 2008 to 2014. Health professionals and hospital beds per 1000 population were used for measuring health resources, and the hospitalization rate was used for access. Descriptive analysis and the fixed effect model were used in this study. Health resources and access increased by about 50% between 2008 and 2014 in rural China. The counties in richer quintiles got more health resources and hospitalizations. As for health professionals, the absolute differences between the richer and the poorest quintile were significantly enlarging in 2014 when compared to 2008. Regarding the hospitalization rate, the differences between the richest and the poorest quintile showed no significant change after 2012. In sum, absolute inequalities of health resources were increased, while that of health utilization kept constant following China's health care reform. The reform needs to continually recruit qualified health workers and appropriately allocate health infrastructures to strengthen the capacity of the health care system in the impoverished areas.

Keywords: China; access; health care reform; health resource; inequality.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The density of health professionals by GDP per capita quintile, 2008–2014.
Figure 2
Figure 2
The density of hospital beds by GDP per capita quintile, 2008–2014.
Figure 3
Figure 3
The hospitalization rate by GDP per capita quintile, 2008–2014.
See this image and copyright information in PMC

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