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Identification of the Differential Effect of City-Level on the Gini Coefficient of Health Service Delivery in Online Health Community

Inequality of health services for different specialty categories not only occurs in different areas in the world, but also happens in the online service platform. In the online health community (OHC), health services often display inequality for different specialty categories, including both online...

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Autores principales: Yu, Hai-Yan, Chen, Jing-Jing, Wang, Jying-Nan, Chiu, Ya-Ling, Qiu, Hang, Wang, Li-Ya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6651774/
https://www.ncbi.nlm.nih.gov/pubmed/31261952
http://dx.doi.org/10.3390/ijerph16132314
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author Yu, Hai-Yan
Chen, Jing-Jing
Wang, Jying-Nan
Chiu, Ya-Ling
Qiu, Hang
Wang, Li-Ya
author_facet Yu, Hai-Yan
Chen, Jing-Jing
Wang, Jying-Nan
Chiu, Ya-Ling
Qiu, Hang
Wang, Li-Ya
author_sort Yu, Hai-Yan
collection PubMed
description Inequality of health services for different specialty categories not only occurs in different areas in the world, but also happens in the online service platform. In the online health community (OHC), health services often display inequality for different specialty categories, including both online views and medical consultations for offline registered services. Moreover, how the city-level factors impact the inequality of health services in OHC is still unknown. We designed a causal inference study with data on distributions of serviced patients and online views in over 100 distinct specialty categories on one of the largest OHCs in China. To derive the causal effect of the city-levels (two levels inducing 1 and 0) on the Gini coefficient, we matched the focus cases in cities with rich healthcare resources with the potential control cities. For each of the specialty categories, we first estimated the average treatment effect of the specialty category’s Gini coefficient (SCGini) with the balanced covariates. For the Gini coefficient of online views, the average treatment effect of level-1 cities is 0.573, which is 0.016 higher than that of the matched group. Similarly, for the Gini coefficient of serviced patients, the average treatment effect of level-1 cities is 0.470, which is 0.029 higher than that of the matched group. The results support the argument that the total Gini coefficient of the doctors in OHCs shows that the inequality in health services is still very serious. This study contributes to the development of a theoretically grounded understanding of the causal effect of city-level factors on the inequality of health services in an online to offline health service setting. In the future, heterogeneous results should be considered for distinct groups of doctors who provide different combinations of online contributions and online attendance.
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spelling pubmed-66517742019-08-08 Identification of the Differential Effect of City-Level on the Gini Coefficient of Health Service Delivery in Online Health Community Yu, Hai-Yan Chen, Jing-Jing Wang, Jying-Nan Chiu, Ya-Ling Qiu, Hang Wang, Li-Ya Int J Environ Res Public Health Article Inequality of health services for different specialty categories not only occurs in different areas in the world, but also happens in the online service platform. In the online health community (OHC), health services often display inequality for different specialty categories, including both online views and medical consultations for offline registered services. Moreover, how the city-level factors impact the inequality of health services in OHC is still unknown. We designed a causal inference study with data on distributions of serviced patients and online views in over 100 distinct specialty categories on one of the largest OHCs in China. To derive the causal effect of the city-levels (two levels inducing 1 and 0) on the Gini coefficient, we matched the focus cases in cities with rich healthcare resources with the potential control cities. For each of the specialty categories, we first estimated the average treatment effect of the specialty category’s Gini coefficient (SCGini) with the balanced covariates. For the Gini coefficient of online views, the average treatment effect of level-1 cities is 0.573, which is 0.016 higher than that of the matched group. Similarly, for the Gini coefficient of serviced patients, the average treatment effect of level-1 cities is 0.470, which is 0.029 higher than that of the matched group. The results support the argument that the total Gini coefficient of the doctors in OHCs shows that the inequality in health services is still very serious. This study contributes to the development of a theoretically grounded understanding of the causal effect of city-level factors on the inequality of health services in an online to offline health service setting. In the future, heterogeneous results should be considered for distinct groups of doctors who provide different combinations of online contributions and online attendance. MDPI 2019-06-29 2019-07 /pmc/articles/PMC6651774/ /pubmed/31261952 http://dx.doi.org/10.3390/ijerph16132314 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yu, Hai-Yan
Chen, Jing-Jing
Wang, Jying-Nan
Chiu, Ya-Ling
Qiu, Hang
Wang, Li-Ya
Identification of the Differential Effect of City-Level on the Gini Coefficient of Health Service Delivery in Online Health Community
title Identification of the Differential Effect of City-Level on the Gini Coefficient of Health Service Delivery in Online Health Community
title_full Identification of the Differential Effect of City-Level on the Gini Coefficient of Health Service Delivery in Online Health Community
title_fullStr Identification of the Differential Effect of City-Level on the Gini Coefficient of Health Service Delivery in Online Health Community
title_full_unstemmed Identification of the Differential Effect of City-Level on the Gini Coefficient of Health Service Delivery in Online Health Community
title_short Identification of the Differential Effect of City-Level on the Gini Coefficient of Health Service Delivery in Online Health Community
title_sort identification of the differential effect of city-level on the gini coefficient of health service delivery in online health community
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6651774/
https://www.ncbi.nlm.nih.gov/pubmed/31261952
http://dx.doi.org/10.3390/ijerph16132314
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