Inequality And Decomposition Of Health Care Between Urban And Rural Residents

In the new era,the main social contradictions in China have changed,and the need of equality turn out to be a key factor when people seek for good life.The utilization of health care is the important way to maintain health.Only the health care resources been used equally and efficiently that citizen health level could be improved,hence can prompt the healthy China.In the past,researchers analyzed and studied the inequality of health care utilization from the perspectives of income,medical insurance and medical resources,disregarding the fact that the connotation of inequality of health care utilization have changed in the new era.Therefore,they’re lack of the consideration for the correlation between inequality of health care utilization and geographical factors.Moreover,from the existing studies,there are few studies on the inequality of health care utilization separated by disease.In order to know about the current situation of health care utilization for urban and rural residents and find the cause why inequity occurs,finally to improve equality level for health care and also provide scientific data to continue improve residents health.Based on the basic medical insurance data of urban and rural residents in city X,taking diabetes patients as the research object,this paper measures and decompose the inequality of health care utilization of urban and rural residents.Firstly,this paper develops the theoretical analysis framework of the research on the inequality of health care utilization through literature review.Secondly,by filter and processing big data retrieved from medical insurance system,formulate the data set required for the research,and analyze the basic characteristics of the research object and the current situation of health care utilization.The relative importance of health care services was explored by using Relative Importance(RI)and multiple regression(OLS)methods.Finally,the Gini coefficient is used to measure the inequality of health care utilization.Combined with the regression analysis of Recentered Influence Function(RIF)and the group decomposition of Gini coefficient,the influence and mechanism of “Unneeded variable”including geographical elements on the inequality of health care utilization are explored.The findings are as follows:(1)There are significant differences in the utilization of health care during different stages in same disease.The primary medical institutions are the main choice for diabetes;limited medical can provided by the second level hospitals;when come to later stage,the diabetes strongly depend on the third level hospitals.(2)The regression and decomposition results of health care utilization inequality indicate the course of disease has an inhibitory effect on health care utilization inequality,the more serious the disease is,the smaller impact on health care utilization inequality;hospital grade has a positive impact in promoting health care utilization inequality,and the influence of hospital grade on health care utilization inequality is regulated by regional variables;In the empirical test,not find enough evidence to prove different household registration has a significant or stable impact on the inequality of health care utilization.(3)The connotation of geographical inequality of health care utilization as follows: the inequality of health care utilization is more prominent in the central area where have rich medical resources.The urban diabetes in there tend to obtain high-quality medical resources,while urban diabetes in the rural area have little access to high-quality health care.Based on the above conclusions,this paper proposes to optimize the distribution of medical resources,allocate medical resources reasonably;promote the high-quality development of primary clinics,realize the orderly sinking of high-quality medical resources;play a positive role by the government and superior hospitals,promote the development of secondary medical institutions;strengthen the prevention and control and management of chronic diseases,and complete the full cycle health management of chronic diseases.