Health Care Access and Regional Disparities in China
Access to health care, as a determinant of health, became unequally distributed in China as a result of continued pursuit of the market-oriented reforms introduced the late 1970s. Increasing urban-rural socio-economic disparities jeopardized the equity in social welfare and particularly the equity o...
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| I publikationen: | URI:https://journals.openedition.org/eps, |
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| Huvudupphovsmän: | , |
| Materialtyp: | Article ou chapitre numérique |
| Publicerad: |
Espace populations sociétés
2011
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| Ämnen: | |
| Länkar: | Accès Université d'Orléans et IFPM Accès Université d'Orléans et IFPM |
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openedition-oai:revues.org:eps_4345 |
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| record_format |
openedition |
| collection |
OpenEdition Journal |
| format |
Article ou chapitre numérique |
| building |
0/Bibliothèque numérique/ 1/Bibliothèque numérique/OpenEdition Journals/ |
| topic |
accès accessibilité Chine disparités régionales soins de santé accessibility access health care regional disparities |
| spellingShingle |
accès accessibilité Chine disparités régionales soins de santé accessibility access health care regional disparities Vedom, Julia Cao, Huhua Health Care Access and Regional Disparities in China |
| description |
Access to health care, as a determinant of health, became unequally distributed in China as a result of continued pursuit of the market-oriented reforms introduced the late 1970s. Increasing urban-rural socio-economic disparities jeopardized the equity in social welfare and particularly the equity of access to health care, which has been widely considered a key objective of health care policies, in turn putting the disadvantaged communities in especially vulnerable position by increasing their health risks. Using the household survey data from the China Health and Nutrition Survey (CHNS), changes in the accessibility of health care are herein examined at the household level across socioeconomic groups in nine provinces of China over the 1989-2004 period. First, we describe the access to health care over the 15 years of survey, and then using a multivariate regression we analyze the determinants of access in 2004. We find that the geographic accessibility gap between hospitals and clinics has decreased from 1989 to 2004, while the gap in financial accessibility has increased, making urban hospitals the least accessible facilities. This study concludes a strong correlation between the geographic factors (method of travel, region, and availability of infrastructure in the province of residence) and the quality of access received. Overall, patients who are able to reach the facilities on foot enjoy better access than those who can not. Similarly, residents of the West along with the provinces with higher availability of health care facilities also tend to have a better potential access than their counterparts. Understanding of health care utilization patterns and access issues is essential for informing public decision- and policy-making aimed at improving living conditions and building a harmonious society. |
| author |
Vedom, Julia Cao, Huhua |
| author_facet |
Vedom, Julia Cao, Huhua |
| author_sort |
Vedom, Julia |
| title |
Health Care Access and Regional Disparities in China |
| title_short |
Health Care Access and Regional Disparities in China |
| title_full |
Health Care Access and Regional Disparities in China |
| title_fullStr |
Health Care Access and Regional Disparities in China |
| title_full_unstemmed |
Health Care Access and Regional Disparities in China |
| title_sort |
health care access and regional disparities in china |
| publisher |
Espace populations sociétés |
| publishDate |
2011 |
| container_title |
URI:https://journals.openedition.org/eps |
| url |
https://ezproxy.univ-orleans.fr/login?url=https://doi.org/10.4000/eps.4345 https://ezproxy.univ-orleans.fr/login?url=https://journals.openedition.org/eps/4345 |
| _version_ |
1877294577346412545 |
| spelling |
openedition-oai:revues.org:eps_4345 https://doi.org/10.4000/eps.4345 urn:doi:10.4000/eps.4345 https://journals.openedition.org/eps/4345 2011-10-05T13:12:21Z info:eu-repo/semantics/openAccess article info:eu-repo/semantics/article urn:handle:20.500.13089/fth4 https://creativecommons.org/licenses/by-nc-nd/4.0/ Health Care Access and Regional Disparities in China Espace populations sociétés Université de Lille info:eu-repo/semantics/reference/issn/2104-3752 info:eu-repo/semantics/reference/issn/0755-7809 URI:https://journals.openedition.org/eps Vedom, Julia Cao, Huhua accès accessibilité Chine disparités régionales soins de santé accessibility access health care regional disparities Access to health care, as a determinant of health, became unequally distributed in China as a result of continued pursuit of the market-oriented reforms introduced the late 1970s. Increasing urban-rural socio-economic disparities jeopardized the equity in social welfare and particularly the equity of access to health care, which has been widely considered a key objective of health care policies, in turn putting the disadvantaged communities in especially vulnerable position by increasing their health risks. Using the household survey data from the China Health and Nutrition Survey (CHNS), changes in the accessibility of health care are herein examined at the household level across socioeconomic groups in nine provinces of China over the 1989-2004 period. First, we describe the access to health care over the 15 years of survey, and then using a multivariate regression we analyze the determinants of access in 2004. We find that the geographic accessibility gap between hospitals and clinics has decreased from 1989 to 2004, while the gap in financial accessibility has increased, making urban hospitals the least accessible facilities. This study concludes a strong correlation between the geographic factors (method of travel, region, and availability of infrastructure in the province of residence) and the quality of access received. Overall, patients who are able to reach the facilities on foot enjoy better access than those who can not. Similarly, residents of the West along with the provinces with higher availability of health care facilities also tend to have a better potential access than their counterparts. Understanding of health care utilization patterns and access issues is essential for informing public decision- and policy-making aimed at improving living conditions and building a harmonious society. La poursuite continuelle des réformes orientées vers le marché introduites en Chine pendant la fin des années 1970, a provoqué une augmentation des disparités urbaines et rurales, intra- et interrégionales, ainsi que socio-économiques. Ces circonstances ont soulevé des questions multiples concernant l’équité, suggérant les tendances qui devraient être attentivement suivies. Tandis qu'il existe un consensus au sujet du besoin et de l'importance d’équité en matière d'accès, à ce jour peu de recherches géographiques ont été conduites dans ce domaine. À la lumière de ces enjeux, utilisant l’Enquête sur la santé et la nutrition en Chine (CHNS), cette étude vise à examiner ces changements sur l'accessibilité des soins de santé au niveau des ménages entre les groupes socio-économiques dans neuf provinces de la Chine entre 1989 et 2004. Tout d'abord, nous décrivons l'accès aux soins de santé au cours des 15 années d'enquête, puis, en utilisant une régression multivariée, nous analysons les déterminants de l'accès en 2004. Les résultats de l'analyse montrent qu'entre 1989 et 2004 l'inégalité en matière d’accessibilité entre les hôpitaux et les cliniques a diminué en termes d'indicateurs géographiques, alors que l’inégalité en matière d’accessibilité financière a augmenté, rendant les soins de santé dans les hôpitaux urbains moins accessibles. Nous trouvons que l'accès aux hôpitaux et aux cliniques dans les secteurs urbains et ruraux est la plupart du temps conditionné par des facteurs géographiques comme le transport, la région de résidence et la disponibilité des soins de santé. La compréhension des tendances à l'utilisation des soins de santé et aux problèmes d'accès est indispensable afin d’informer les instances publiques et d'élaborer des politiques visant à améliorer les conditions de vie et à construire une société harmonieuse. |