Influencing factors of inequity in health care utilization among the elderly in China / 中国卫生政策研究

ABSTRACT

Objectives:This paper at measuring the inequity and its influencing factors of medical care utiliza-tion of elderly aged above 60 ( inclusive) . Methods:data comes from 2013 China Health and Retirement Longitudinal Study ( CHARLS) where the population aged 60 and above was selected as the research object. Concentration index ( CI) and its decomposition or centralized curve was used to measure the inequity of medical care services utilization of the elderly, and then the influencing factors of inequity were analyzed by means of the centralized index. Results:The concentration index for outpatient and inpatient service utilization for the elderly was 0 . 0619 and 0 . 1050 , re-spectively, and the concentration curves were below the absolute fair line. The top 2 factors that showed positive con-tribution to the outpatient service utilization included annual per capita consumption expenditure and the pension a-mount. The top 2 factors that showed negative contribution and larger contribution rate to the outpatient service utiliza-tion included New Rural Cooperative Medical Insurance (NRCMI), and Physical Ability in Daily Life (PADL). The top 2 factors that positively and highly contributed to the inpatient service utilization included the household per capita consumption expenditure and the Urban Employees' Basic Medical Insurance (UEBMI). The top 2 factors that nega-tively contributed to the inpatient service utilization included the New Rural Cooperative Medical Insurance ( NRCMI) and the Physical Ability in Daily Life ( PADL) . The horizontal inequity of outpatient and inpatient service utilization was 0. 0739 and 0. 1339, respectively, indicating that there was unfairness in the use of outpatient and inpatient services among elderly. Conclusion:There is inequity of medical care service utilization among the elderly in China. The economic status contributes the largest part of inequity, meaning that it is unfair to the first contribution factor;while the Needs-based fac-tors and New Rural Cooperative Medical Insurance (NRCMI) showed an inequity, narrowing the unfair gap.