Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage

Xu, Jianqiang; Zheng, Juan; Xu, Lingzhong; Wu, Hongtao

doi:10.3390/ijerph18020593

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Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage

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School of Management, Xuzhou Medical University, Xuzhou 221004, China

School of Public Health, Shandong University, Jinan 250012, China

School of Management, Tsinghua University, Beijing 100084, China

Author to whom correspondence should be addressed.

Int. J. Environ. Res. Public Health 2021, 18(2), 593; https://doi.org/10.3390/ijerph18020593

Received: 19 November 2020 / Revised: 7 January 2021 / Accepted: 8 January 2021 / Published: 12 January 2021

(This article belongs to the Special Issue Cost Effectiveness Analysis of Health Service Intervention)

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Abstract

Worldwide countries are recognising the need for and significance of universal health coverage (UHC); however, health inequality continues to persist. This study evaluates the status and equity of residents’ demand for and utilisation of health services and expenditure by considering the three components of universal health coverage, urban-rural differences, and different income groups. Sample data from China’s Fifth Health Service Survey were analysed and the ‘five levels of income classification’ were used to classify people into income groups. This study used descriptive analysis and concentration index and concentration curve for equity evaluation. Statistically significant differences were found in the demand and utilisation of health services between urban and rural residents. Rural residents’ demand and utilisation of health services decreased with an increase in income and their health expenditure was higher than that of urban residents. Compared with middle- and high-income rural residents, middle- and lower-income rural residents faced higher hospitalisation expenses; and, compared with urban residents, equity in rural residents’ demand and utilisation of health services, and annual health and hospitalisation expenditures, were poorer. Thus, equity of health service utilisation and expenditure for urban and rural residents with different incomes remain problematic, requiring improved access and health policies. View Full-Text

Keywords: demand for health services; utilisation of health services; health expenditure; equity evaluation; urban-rural differences; universal health coverage

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MDPI and ACS Style

Xu, J.; Zheng, J.; Xu, L.; Wu, H. Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage. Int. J. Environ. Res. Public Health 2021, 18, 593. https://doi.org/10.3390/ijerph18020593

AMA Style

Xu J, Zheng J, Xu L, Wu H. Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage. International Journal of Environmental Research and Public Health. 2021; 18(2):593. https://doi.org/10.3390/ijerph18020593

Chicago/Turabian Style

Xu, Jianqiang, Juan Zheng, Lingzhong Xu, and Hongtao Wu. 2021. "Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage" International Journal of Environmental Research and Public Health 18, no. 2: 593. https://doi.org/10.3390/ijerph18020593

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Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage

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