Exploring unmet healthcare needs and associated inequalities among middle-aged and older adults in Eastern China during the progression toward universal health coverage.

IF 2.7 3区 经济学 Q1 ECONOMICS
Yunhan Wang, Nan Jiang, Haiya Shao, Zhonghua Wang
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引用次数: 0

Abstract

Background: Given the rapid population aging in China, achieving universal health coverage (UHC) presents a primary challenge in addressing unmet healthcare needs and associated inequalities among middle-aged and older adults. Several studies have focused on healthcare utilization and its inequalities, but little attention has been paid to the inequality in unmet healthcare needs. This study aimed to analyze the inequalities in unmet the healthcare needs of middle-aged and older adults in eastern China during the progression toward UHC.

Methods: Data were obtained from the fourth, fifth, and sixth National Health Service Survey (NHSS) of Jiangsu Province, located in eastern China, during the years 2008, 2013, and 2018, respectively. Logistic regression models were used to assess the associated factors of unmet healthcare needs. The inequality was measured according to the concentration index (CI) and its decomposition.

Results: In this study, we found that 12.86%, 2.22%, and 48.89% of middle-aged and older adults reported unmet needs for outpatient and inpatient services and physical examinations, respectively. The prevalence of unmet outpatient needs increased from 2008 to 2018, while the prevalence of unmet inpatient services was lower but maintained. The prevalence of unmet needs for physical examinations among middle-aged and older adults markedly decreased since 2008. Rural areas had a higher prevalence of unmet needs for inpatient services and physical examinations than urban areas. Unmet healthcare needs were more prevalent among the poor. The pro-poor inequalities of unmet healthcare needs have been mitigated during the progression toward UHC; however, they remain predominant among rural middle-aged and older adults for outpatient and inpatient services. Socioeconomic factors significantly influenced unmet healthcare needs and contributed to their inequalities.

Conclusions: The findings characterize the prevalence and inequality of unmet healthcare need among middle-aged and older adults in eastern China during the progression toward UHC. Policy interventions should be actively advocated to effectively mitigate the unmet healthcare needs and address the associated inequalities.

探索华东地区中老年人在全民医保进程中未得到满足的医疗需求及相关的不平等现象。
背景:鉴于中国人口的快速老龄化,实现全民医保(UHC)是解决中老年人未得到满足的医疗需求和相关不平等问题的首要挑战。已有多项研究关注了医疗保健利用率及其不平等问题,但很少有人关注未满足的医疗保健需求的不平等问题。本研究旨在分析华东地区中老年人在向全民医保迈进的过程中未得到满足的医疗需求的不平等现象:数据来源于中国东部地区江苏省分别于 2008 年、2013 年和 2018 年进行的第四次、第五次和第六次国家卫生服务调查(NHSS)。采用逻辑回归模型评估未满足医疗需求的相关因素。根据集中指数(CI)及其分解来衡量不平等程度:在这项研究中,我们发现分别有 12.86%、2.22% 和 48.89% 的中老年人报告其门诊、住院服务和体检需求未得到满足。从 2008 年到 2018 年,门诊需求未得到满足的流行率有所上升,而住院服务需求未得到满足的流行率较低,但仍保持不变。自 2008 年以来,中老年人体检需求未得到满足的流行率明显下降。与城市地区相比,农村地区住院服务和体检需求未得到满足的比例更高。未满足的医疗保健需求在贫困人口中更为普遍。在向全民健康计划迈进的过程中,未满足的医疗保健需求对贫困人口造成的不平等有所缓解;但在农村中老年人中,未满足的门诊和住院服务需求仍占主导地位。社会经济因素在很大程度上影响了未满足的医疗保健需求,并导致了这些需求的不平等:结论:研究结果表明,在实现全民医保的过程中,华东地区中老年人未满足医疗需求的普遍性和不平等性。应积极倡导政策干预,以有效缓解未满足的医疗需求,并解决相关的不平等问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.90
自引率
4.20%
发文量
59
审稿时长
13 weeks
期刊介绍: Health Economics Review is an international high-quality journal covering all fields of Health Economics. A broad range of theoretical contributions, empirical studies and analyses of health policy with a health economic focus will be considered for publication. Its scope includes macro- and microeconomics of health care financing, health insurance and reimbursement as well as health economic evaluation, health services research and health policy analysis. Further research topics are the individual and institutional aspects of health care management and the growing importance of health care in developing countries.
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