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Trend of Urban-Rural Disparities in Hospital Admissions and Medical Expenditure in China from 2003 to 2011

OBJECTIVES: To assess the trend of urban-rural disparities in hospital admissions and medical expenditure between 2003 and 2011 in the context of Chinese health-care system reform. METHODS: The data were from three different national surveys: the Third National Health Services Survey in 2003, the Fo...

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Autores principales: Fu, Rong, Wang, Yupeng, Bao, Han, Wang, Zhiqiang, Li, Yongquan, Su, Shaofei, Liu, Meina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4177550/
https://www.ncbi.nlm.nih.gov/pubmed/25251367
http://dx.doi.org/10.1371/journal.pone.0108571
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author Fu, Rong
Wang, Yupeng
Bao, Han
Wang, Zhiqiang
Li, Yongquan
Su, Shaofei
Liu, Meina
author_facet Fu, Rong
Wang, Yupeng
Bao, Han
Wang, Zhiqiang
Li, Yongquan
Su, Shaofei
Liu, Meina
author_sort Fu, Rong
collection PubMed
description OBJECTIVES: To assess the trend of urban-rural disparities in hospital admissions and medical expenditure between 2003 and 2011 in the context of Chinese health-care system reform. METHODS: The data were from three different national surveys: the Third National Health Services Survey in 2003, the Fourth National Health Services Survey in 2008 and the national health-care reform phased assessment survey in 2011. There were 151421, 143380 and 48356 respondents aged 15 years or older in 2003, 2008 and 2011, respectively. RESULTS: The health insurance coverage expanded considerably from 27.7% in 2003 to 96.4% in 2011 among respondents aged 15 years or older. Hospitalization rate increased rapidly from 4.1% in 2003 to 9.6% in 2011. Urban respondents had higher hospital admissions than rural respondents, and the RR (95% CI) of hospitalization was 1.23 (1.17–1.30), 1.06 (1.02–1.10) and 1.16 (1.10–1.23) in 2003, 2008 and 2011, respectively. The urban-rural disparity in hospital admissions significantly narrowed over time. Urban respondents had a higher admission rate if insured and a lower admission if not insured than their rural counterparts. Of the six medical expenditure measures, the disparities in reimbursement rate and the proportion of hospitalization direct cost to the total consumer spending significantly narrowed. CONCLUSIONS: The health insurance coverage has been continually expanding and health service utilization has been substantially improved. Urban-rural disparities have been narrowed but still exist. Therefore, policy-makers should focus on increasing investment and reimbursement levels, developing a uniform standard health insurance system for urban and rural residents and improving the medical assistance system.
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spelling pubmed-41775502014-10-02 Trend of Urban-Rural Disparities in Hospital Admissions and Medical Expenditure in China from 2003 to 2011 Fu, Rong Wang, Yupeng Bao, Han Wang, Zhiqiang Li, Yongquan Su, Shaofei Liu, Meina PLoS One Research Article OBJECTIVES: To assess the trend of urban-rural disparities in hospital admissions and medical expenditure between 2003 and 2011 in the context of Chinese health-care system reform. METHODS: The data were from three different national surveys: the Third National Health Services Survey in 2003, the Fourth National Health Services Survey in 2008 and the national health-care reform phased assessment survey in 2011. There were 151421, 143380 and 48356 respondents aged 15 years or older in 2003, 2008 and 2011, respectively. RESULTS: The health insurance coverage expanded considerably from 27.7% in 2003 to 96.4% in 2011 among respondents aged 15 years or older. Hospitalization rate increased rapidly from 4.1% in 2003 to 9.6% in 2011. Urban respondents had higher hospital admissions than rural respondents, and the RR (95% CI) of hospitalization was 1.23 (1.17–1.30), 1.06 (1.02–1.10) and 1.16 (1.10–1.23) in 2003, 2008 and 2011, respectively. The urban-rural disparity in hospital admissions significantly narrowed over time. Urban respondents had a higher admission rate if insured and a lower admission if not insured than their rural counterparts. Of the six medical expenditure measures, the disparities in reimbursement rate and the proportion of hospitalization direct cost to the total consumer spending significantly narrowed. CONCLUSIONS: The health insurance coverage has been continually expanding and health service utilization has been substantially improved. Urban-rural disparities have been narrowed but still exist. Therefore, policy-makers should focus on increasing investment and reimbursement levels, developing a uniform standard health insurance system for urban and rural residents and improving the medical assistance system. Public Library of Science 2014-09-24 /pmc/articles/PMC4177550/ /pubmed/25251367 http://dx.doi.org/10.1371/journal.pone.0108571 Text en © 2014 Fu et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Fu, Rong
Wang, Yupeng
Bao, Han
Wang, Zhiqiang
Li, Yongquan
Su, Shaofei
Liu, Meina
Trend of Urban-Rural Disparities in Hospital Admissions and Medical Expenditure in China from 2003 to 2011
title Trend of Urban-Rural Disparities in Hospital Admissions and Medical Expenditure in China from 2003 to 2011
title_full Trend of Urban-Rural Disparities in Hospital Admissions and Medical Expenditure in China from 2003 to 2011
title_fullStr Trend of Urban-Rural Disparities in Hospital Admissions and Medical Expenditure in China from 2003 to 2011
title_full_unstemmed Trend of Urban-Rural Disparities in Hospital Admissions and Medical Expenditure in China from 2003 to 2011
title_short Trend of Urban-Rural Disparities in Hospital Admissions and Medical Expenditure in China from 2003 to 2011
title_sort trend of urban-rural disparities in hospital admissions and medical expenditure in china from 2003 to 2011
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4177550/
https://www.ncbi.nlm.nih.gov/pubmed/25251367
http://dx.doi.org/10.1371/journal.pone.0108571
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