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

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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

Content Provider	MDPI
Author	Towne, Samuel Liu, Xiaojun Li, Rui Smith, Matthew Maddock, Jay Tan, Anran Hayek, Samah Zelber-Sagi, Shira Jiang, Xiaoqing Ruan, Haotian Yuan, Zhaokang
Copyright Year	2021
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.
Starting Page	6113
e-ISSN	16604601
DOI	10.3390/ijerph18116113
Journal	International Journal of Environmental Research and Public Health
Issue Number	11
Volume Number	18
Language	English
Publisher	MDPI
Publisher Date	2021-06-06
Access Restriction	Open
Subject Keyword	International Journal of Environmental Research and Public Health Social Sciences, Interdisciplinary Health Inequities Access Social Determinants Costs Hospitals
Content Type	Text
Resource Type	Article

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