TY - JOUR
T1 - Assessing Income-Related Health Inequality and Horizontal Inequity in China
AU - Zhou, Zhongliang
AU - Fang, Yu
AU - Zhou, Zhiying
AU - Li, Dan
AU - Wang, Dan
AU - Li, Yangli
AU - Lu, Li
AU - Gao, Jianmin
AU - Chen, Gang
PY - 2017/5/1
Y1 - 2017/5/1
N2 - The study aims to investigate both income-related health inequality and horizontal equity in urban and rural China. The 4th and 5th National Health Services Survey, and extended samples in Shaanxi Province surveyed in 2008 and 2013, were analysed. Health outcome was measured using the EQ-5D-3L utility, scored by the Chinese-specific tariff. The concentration index was calculated to measure the degree of income-related health inequality and was further decomposed to study the strength of different contributing factors to explain health inequality. The horizontal inequity was further measured based on the decomposition results. The final study sample consists of 15,505 respondents in 2008 and 48,808 respondents in 2013. Descriptive analysis shows that compared to 2008, respondents in both urban and rural China reported worse HRQoL in 2013. There was a pro-rich inequality of HRQoL in both urban and rural China. Controlling for demographic factors, the pro-rich inequity of HRQoL remains. Economic and educational statuses are found to be two key factors explaining the pro-rich inequity. The establishment of basic medical insurance has shown a mixed effect on reducing health inequality. Strategies to reduce the inequality of residents’ economic and educational status, through further implementing the poverty reduction policies, should be prioritised by the local government.
AB - The study aims to investigate both income-related health inequality and horizontal equity in urban and rural China. The 4th and 5th National Health Services Survey, and extended samples in Shaanxi Province surveyed in 2008 and 2013, were analysed. Health outcome was measured using the EQ-5D-3L utility, scored by the Chinese-specific tariff. The concentration index was calculated to measure the degree of income-related health inequality and was further decomposed to study the strength of different contributing factors to explain health inequality. The horizontal inequity was further measured based on the decomposition results. The final study sample consists of 15,505 respondents in 2008 and 48,808 respondents in 2013. Descriptive analysis shows that compared to 2008, respondents in both urban and rural China reported worse HRQoL in 2013. There was a pro-rich inequality of HRQoL in both urban and rural China. Controlling for demographic factors, the pro-rich inequity of HRQoL remains. Economic and educational statuses are found to be two key factors explaining the pro-rich inequity. The establishment of basic medical insurance has shown a mixed effect on reducing health inequality. Strategies to reduce the inequality of residents’ economic and educational status, through further implementing the poverty reduction policies, should be prioritised by the local government.
KW - China
KW - EQ-5D
KW - Health inequity
KW - Health-related quality of life
KW - Horizontal inequity
UR - http://www.scopus.com/inward/record.url?scp=84952923098&partnerID=8YFLogxK
U2 - 10.1007/s11205-015-1221-1
DO - 10.1007/s11205-015-1221-1
M3 - Article
VL - 132
SP - 241
EP - 256
JO - Social Indicators Research
JF - Social Indicators Research
SN - 0303-8300
IS - 1
ER -