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Measurement and analysis of equity in health: a case study conducted in Zhejiang Province, China

机译:健康股权的测量与分析 - 以浙江省在浙江省进行的案例研究

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Abstract Background Equity is the core of primary care. The issue of equity in health has become urgent, and China has attached increasing attention to it. With rapid economic development and great changes in medical insurance policy, the pattern of equity in health has changed tremendously. The reform of healthcare in Zhejiang Province is at the forefront in China, and studies on Zhejiang Province are of great significance to the entire country. This paper aimed to measure health equity from the perspectives of health needs and health-seeking behavior and to provide suggestions for the next policy formulations, with respect to timeliness. Methods The investigator’s household survey was conducted in August 2016. A sample of 1000 households, which included2807 individuals in Zhejiang, China, was obtained with the multi-stage stratified cluster sampling method. Descriptive analysis and chi-square tests were adopted in the analysis. The value of the concentration index was used to measure the equity. Results This study found that the poor have more urgent health needs and poorer health situations than the rich. Through studies on health-seeking behavior, the utilization of outpatient services was almost equitable, while the utilization of hospitalization showed a pro-rich inequity (i.e., the rich use more services). Individuals with employer-based medical insurance used more outpatient services than those with rural and urban medical insurance. More people in the poorer income groups did not use inpatient services due to financial difficulties. Conclusions Absolute medical prices and medical insurance may explain the equity in the utilization of outpatient services and the inequity in the utilization of hospitalization. In view of the pro-rich inequity of hospitalization, more financial protection should be provided for the poor.
机译:抽象背景股票是初级保健的核心。卫生股权问题已成为迫切状态,中国已加入越来越关注它。随着经济迅速的发展和医疗保险政策的巨大变化,健康状况的股权模式发生了巨大的变化。浙江省医疗保健改革在中国的最前沿,浙江省研究对整个国家具有重要意义。本文旨在从健康需求和寻求健康行为的角度来衡量健康权益,并为及时性提供下一个政策制定的建议。方法采用多阶段分层集群采样方法获得了1000年8月在2016年8月进行的,其中包括2007家户籍中的1000户,其中包括2007家户籍。在分析中采用了描述性分析和Chi-Square测试。浓度指数的值用于衡量权益。结果本研究发现,穷人具有更紧急的健康需求和较差的健康状况。通过研究寻求保健行为,门诊服务的利用几乎公平,而住院的利用率显示出富裕的不公平(即,丰富的使用更多服务)。基于雇主的医疗保险的个人使用比乡村和城市医疗保险更多的门诊服务。由于财务困难,较贫较差的收入群体中的更多人没有使用住院服务。结论绝对的医疗价格和医疗保险可以解释在利用门诊服务和住院利用时不公平的公平。鉴于住院的富裕不公平,应为穷人提供更多的金融保护。

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