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 and Liu, Meina (2014) Trend of urban-rural disparities in hospital admissions and medical expenditure in China from 2003 to 2011. PLoS One, 9 9: e108571.1-e108571.7. doi:10.1371/journal.pone.0108571


Author Fu, Rong
Wang, Yupeng
Bao, Han
Wang, Zhiqiang
Li, Yongquan
Su, Shaofei
Liu, Meina
Title Trend of urban-rural disparities in hospital admissions and medical expenditure in China from 2003 to 2011
Journal name PLoS One   Check publisher's open access policy
ISSN 1932-6203
Publication date 2014-09-24
Sub-type Article (original research)
DOI 10.1371/journal.pone.0108571
Open Access Status DOI
Volume 9
Issue 9
Start page e108571.1
End page e108571.7
Total pages 7
Place of publication San Francisco, CA, United States
Publisher Public Library of Science
Collection year 2015
Language eng
Formatted abstract
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.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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Created: Tue, 30 Sep 2014, 06:25:26 EST by Zhiqiang Wang on behalf of Medicine - Royal Brisbane and Women's Hospital