Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/328621 
Year of Publication: 
2022
Citation: 
[Journal:] Economies [ISSN:] 2227-7099 [Volume:] 10 [Issue:] 12 [Article No.:] 321 [Year:] 2022 [Pages:] 1-23
Publisher: 
MDPI, Basel
Abstract: 
In recent decades, China has experienced rapid economic growth and rising health inequality. The government has introduced a nationwide health care reform aimed at achieving affordable and equitable basic health care for all. This paper investigates income-related inequality in health care utilization and out-of-pocket (OOP) payments and explores the underlying factors that drive the inequalities. Using data running from 2000 to 2015 and covering nine of thirty-one provinces in China, we calculate indices to measure income-related inequality and adopt a regression-based decomposition approach to explore the sources of inequality. We find pro-rich inequality in the use of preventive care and pro-poor inequality in the use of folk doctors. In addition, the better-off have preferential access to higher level hospitals, while the use of primary care facilities is more concentrated among the poor. The poor are also found to face a heavier financial burden since they tend to spend a larger share of their income on OOP payments. Education, employment and geographic regions all appear to contribute to the total inequality. Our results indicate that affordability remains a common barrier for the poor to access health care, and that the inequality is largely driven by socio-economic factors.
Subjects: 
China
decomposition analysis
health care utilization
income-related inequality of health
out-of-pocket payments
Persistent Identifier of the first edition: 
Creative Commons License: 
cc-by Logo
Document Type: 
Article

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