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Social and Structural Determinants of Health Inequities: Socioeconomic, Transportation-Related, and Provincial-Level Indicators of Cost-Related Forgone Hospital Care in China

Despite near universal health insurance coverage in China, populations with low incomes may still face barriers in access and utilization of affordable health care. We aimed to identify the likelihood of forgone medical care due to cost by surveying individuals from the community to assess: (1) The...

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Autores principales: Towne, Samuel D., Liu, Xiaojun, Li, Rui, Smith, Matthew Lee, Maddock, Jay E., Tan, Anran, Hayek, Samah, Zelber-Sagi, Shira, Jiang, Xiaoqing, Ruan, Haotian, Yuan, Zhaokang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8201337/
https://www.ncbi.nlm.nih.gov/pubmed/34204018
http://dx.doi.org/10.3390/ijerph18116113
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author Towne, Samuel D.
Liu, Xiaojun
Li, Rui
Smith, Matthew Lee
Maddock, Jay E.
Tan, Anran
Hayek, Samah
Zelber-Sagi, Shira
Jiang, Xiaoqing
Ruan, Haotian
Yuan, Zhaokang
author_facet Towne, Samuel D.
Liu, Xiaojun
Li, Rui
Smith, Matthew Lee
Maddock, Jay E.
Tan, Anran
Hayek, Samah
Zelber-Sagi, Shira
Jiang, Xiaoqing
Ruan, Haotian
Yuan, Zhaokang
author_sort Towne, Samuel D.
collection PubMed
description Despite near universal health insurance coverage in China, populations with low incomes may still face barriers in access and utilization of affordable health care. We aimed to identify the likelihood of forgone medical care due to cost by surveying individuals from the community to assess: (1) The percent with forgone medical care due to cost; and (2) Factors associated with forgone medical care due to cost. Surveys conducted (2016–2017) in Mandarin included demographic and medical care utilization-related items. Theoretically-informed, fully-adjusted analyses were employed. Approximately 94% of respondents had health insurance, which is somewhat similar to national estimates. Overall, 24% of respondents resided in rural areas, with 18% having less than a high school education, and 49% being male. More than 36% reported forgone medical care due to cost in the past 12 months. In fully-adjusted analyses, having lower education, generally not being satisfied with the commute to the hospital, and being a resident of a province with a lower density of physicians were associated with forgone medical care. Cost-related disparities in the access and utilization of needed medical care persist, even with near universal health insurance, which may be due to one’s satisfaction with travel time to healthcare and other community assets.
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spelling pubmed-82013372021-06-15 Social and Structural Determinants of Health Inequities: Socioeconomic, Transportation-Related, and Provincial-Level Indicators of Cost-Related Forgone Hospital Care in China Towne, Samuel D. Liu, Xiaojun Li, Rui Smith, Matthew Lee Maddock, Jay E. Tan, Anran Hayek, Samah Zelber-Sagi, Shira Jiang, Xiaoqing Ruan, Haotian Yuan, Zhaokang Int J Environ Res Public Health Article Despite near universal health insurance coverage in China, populations with low incomes may still face barriers in access and utilization of affordable health care. We aimed to identify the likelihood of forgone medical care due to cost by surveying individuals from the community to assess: (1) The percent with forgone medical care due to cost; and (2) Factors associated with forgone medical care due to cost. Surveys conducted (2016–2017) in Mandarin included demographic and medical care utilization-related items. Theoretically-informed, fully-adjusted analyses were employed. Approximately 94% of respondents had health insurance, which is somewhat similar to national estimates. Overall, 24% of respondents resided in rural areas, with 18% having less than a high school education, and 49% being male. More than 36% reported forgone medical care due to cost in the past 12 months. In fully-adjusted analyses, having lower education, generally not being satisfied with the commute to the hospital, and being a resident of a province with a lower density of physicians were associated with forgone medical care. Cost-related disparities in the access and utilization of needed medical care persist, even with near universal health insurance, which may be due to one’s satisfaction with travel time to healthcare and other community assets. MDPI 2021-06-06 /pmc/articles/PMC8201337/ /pubmed/34204018 http://dx.doi.org/10.3390/ijerph18116113 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Towne, Samuel D.
Liu, Xiaojun
Li, Rui
Smith, Matthew Lee
Maddock, Jay E.
Tan, Anran
Hayek, Samah
Zelber-Sagi, Shira
Jiang, Xiaoqing
Ruan, Haotian
Yuan, Zhaokang
Social and Structural Determinants of Health Inequities: Socioeconomic, Transportation-Related, and Provincial-Level Indicators of Cost-Related Forgone Hospital Care in China
title Social and Structural Determinants of Health Inequities: Socioeconomic, Transportation-Related, and Provincial-Level Indicators of Cost-Related Forgone Hospital Care in China
title_full Social and Structural Determinants of Health Inequities: Socioeconomic, Transportation-Related, and Provincial-Level Indicators of Cost-Related Forgone Hospital Care in China
title_fullStr Social and Structural Determinants of Health Inequities: Socioeconomic, Transportation-Related, and Provincial-Level Indicators of Cost-Related Forgone Hospital Care in China
title_full_unstemmed Social and Structural Determinants of Health Inequities: Socioeconomic, Transportation-Related, and Provincial-Level Indicators of Cost-Related Forgone Hospital Care in China
title_short Social and Structural Determinants of Health Inequities: Socioeconomic, Transportation-Related, and Provincial-Level Indicators of Cost-Related Forgone Hospital Care in China
title_sort social and structural determinants of health inequities: socioeconomic, transportation-related, and provincial-level indicators of cost-related forgone hospital care in china
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8201337/
https://www.ncbi.nlm.nih.gov/pubmed/34204018
http://dx.doi.org/10.3390/ijerph18116113
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