Which Matters for Medical Utilization Equity under Universal Coverage : Insurance System, Region or SES
BACKGROUND: China has achieved universal coverage, with a higher rate of 95% medical insurance. However, huge inequalities are concealed under universal coverage. This article aims to explore the medical insurance utilization disparities over different insurance schemes, regions, and socioeconomic statuses (SES).
METHODS: This study was based on an open-access dataset in 2010, 2012, 2014, and 2016. A longitudinal analysis and separate logistic models were performed.
RESULTS: Urban Employee Basic Medical Insurance (UEBMI) members had an outstanding advantage in specialist visiting over those on the Urban Resident Basic Medical Insurance Scheme (URBMI) (OR = 0.607, p < 0.001) and New Cooperative Medical System (NCMS) (OR = 0.262, p < 0.001). However, in terms of a doctor visiting if a person is sick, the odds of patients in the NCMS receiving a visit were 55.1% ((OR = 1.551; p < 0.05) higher than those on the UEBMI. Compared with west China, the odds of those in the north-east and east were 2.1% (p > 0.05) and 97.2% (OR = 1.972; p < 0.001) higher for seeking medical treatment if sick, and 10.8% (OR = 0.892; p < 0.01) and 42.7% lower (OR = 0.573; p < 0.001) for a specialist visiting. In terms of SES, for each unit of increase in the Standard International Occupational Prestige Scale (SIOPS), the odds of seeking medical treatment decreased by 4.3% (OR = 0.958; p < 0.05), and the odds of a specialist visiting increased by 17.1% (OR = 1.171; p < 0.001) for each unit of the annual income logarithm.
CONCLUSIONS: NCMS members and residents in west China were in a disadvantage status in terms of access to specialists, though had a higher probability of medical care if sick. SES variables were positively correlated with a specialist visiting consistently. We suggest a further focus on healthcare quality in the west and rural areas.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:17 |
|---|---|
| Enthalten in: |
International journal of environmental research and public health - 17(2020), 11 vom: 10. Juni |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Huang, Jiaoling [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Influential factor |
|---|
| Anmerkungen: |
Date Completed 02.10.2020 Date Revised 11.11.2023 published: Electronic Citation Status MEDLINE |
|---|
| doi: |
10.3390/ijerph17114131 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM311110282 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM311110282 | ||
| 003 | DE-627 | ||
| 005 | 20231225141544.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.3390/ijerph17114131 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1037.xml |
| 035 | |a (DE-627)NLM311110282 | ||
| 035 | |a (NLM)32531889 | ||
| 035 | |a (PII)E4131 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Huang, Jiaoling |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Which Matters for Medical Utilization Equity under Universal Coverage |b Insurance System, Region or SES |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 02.10.2020 | ||
| 500 | |a Date Revised 11.11.2023 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: China has achieved universal coverage, with a higher rate of 95% medical insurance. However, huge inequalities are concealed under universal coverage. This article aims to explore the medical insurance utilization disparities over different insurance schemes, regions, and socioeconomic statuses (SES) | ||
| 520 | |a METHODS: This study was based on an open-access dataset in 2010, 2012, 2014, and 2016. A longitudinal analysis and separate logistic models were performed | ||
| 520 | |a RESULTS: Urban Employee Basic Medical Insurance (UEBMI) members had an outstanding advantage in specialist visiting over those on the Urban Resident Basic Medical Insurance Scheme (URBMI) (OR = 0.607, p < 0.001) and New Cooperative Medical System (NCMS) (OR = 0.262, p < 0.001). However, in terms of a doctor visiting if a person is sick, the odds of patients in the NCMS receiving a visit were 55.1% ((OR = 1.551; p < 0.05) higher than those on the UEBMI. Compared with west China, the odds of those in the north-east and east were 2.1% (p > 0.05) and 97.2% (OR = 1.972; p < 0.001) higher for seeking medical treatment if sick, and 10.8% (OR = 0.892; p < 0.01) and 42.7% lower (OR = 0.573; p < 0.001) for a specialist visiting. In terms of SES, for each unit of increase in the Standard International Occupational Prestige Scale (SIOPS), the odds of seeking medical treatment decreased by 4.3% (OR = 0.958; p < 0.05), and the odds of a specialist visiting increased by 17.1% (OR = 1.171; p < 0.001) for each unit of the annual income logarithm | ||
| 520 | |a CONCLUSIONS: NCMS members and residents in west China were in a disadvantage status in terms of access to specialists, though had a higher probability of medical care if sick. SES variables were positively correlated with a specialist visiting consistently. We suggest a further focus on healthcare quality in the west and rural areas | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a influential factor | |
| 650 | 4 | |a longitudinal analysis | |
| 650 | 4 | |a social medical insurance | |
| 650 | 4 | |a utilization equity | |
| 700 | 1 | |a Yuan, Li |e verfasserin |4 aut | |
| 700 | 1 | |a Liang, Hong |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t International journal of environmental research and public health |d 2004 |g 17(2020), 11 vom: 10. Juni |w (DE-627)NLM162777434 |x 1660-4601 |7 nnns |
| 773 | 1 | 8 | |g volume:17 |g year:2020 |g number:11 |g day:10 |g month:06 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.3390/ijerph17114131 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 17 |j 2020 |e 11 |b 10 |c 06 | ||