Socioeconomic inequality in health care use among cancer patients in China: Evidence from the China health and retirement longitudinal study
BackgroundCancer is a major public health problem worldwide and the leading cause of death in China, with increasing incidence and mortality rates. This study sought to assess socioeconomic-related inequalities in health care use among cancer patients in China and to analyze factors associated with...
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Frontiers Media S.A.
2022-08-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.942911/full |
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| author | Huiru Zhang Yu Fu Mingsheng Chen Mingsheng Chen Lei Si |
| author_facet | Huiru Zhang Yu Fu Mingsheng Chen Mingsheng Chen Lei Si |
| author_sort | Huiru Zhang |
| collection | DOAJ |
| description | BackgroundCancer is a major public health problem worldwide and the leading cause of death in China, with increasing incidence and mortality rates. This study sought to assess socioeconomic-related inequalities in health care use among cancer patients in China and to analyze factors associated with this disparity.MethodsThis study used data collected for the China Health and Retirement Longitudinal Study in 2018. Patients who reported having cancer were included. The annual per capita household expenditure was classified into five groups by the quintile method. We calculated the distribution of actual, need-predicted, and need-standardized health care use across different socioeconomic groups among patients with cancer. The concentration index (CI) was used to evaluate inequalities in health care use. Influencing factors of inequalities were measured with the decomposition method.ResultsA total of 392 people diagnosed with cancer were included in this study. The proportion of cancer patients who utilized outpatient and inpatient services was 23.47% and 40.82%, respectively, and the CIs for actual outpatient and inpatient service use were 0.1419 and 0.1960. The standardized CIs (CI for outpatient visits = 0.1549; CI for inpatient services = 0.1802) were also both positive, indicating that affluent cancer patients used more health services. The annual per capita household expenditure was the greatest factor favoring the better-off, which contributed as much as 78.99% and 83.92% to the inequality in outpatient and inpatient services use, followed by high school education (26.49% for outpatient services) and living in a rural village (34.53% for inpatient services). Urban Employee Basic Medical Insurance exacerbated the inequality in inpatient services (21.97%) while having a negative impact on outpatient visits (−22.19%).ConclusionsThere is a pro-rich inequality in outpatient and inpatient services use among cancer patients in China. A lower socioeconomic status is negatively associated with cancer care use. Hence, more targeted financial protection for poor people would relieve cancer patients of the burden caused by the high cost of cancer care. |
| first_indexed | 2024-04-14T03:40:17Z |
| format | Article |
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| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-14T03:40:17Z |
| publishDate | 2022-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-2ad8184c68a944f68df5aa1168724e2b2022-12-22T02:14:34ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-08-011010.3389/fpubh.2022.942911942911Socioeconomic inequality in health care use among cancer patients in China: Evidence from the China health and retirement longitudinal studyHuiru Zhang0Yu Fu1Mingsheng Chen2Mingsheng Chen3Lei Si4School of Health Policy and Management, Nanjing Medical University, Nanjing, ChinaSchool of Health Policy and Management, Nanjing Medical University, Nanjing, ChinaSchool of Health Policy and Management, Nanjing Medical University, Nanjing, ChinaCenter for Global Health, Nanjing Medical University, Nanjing, ChinaThe George Institute for Global Health, UNSW Sydney, Kensington, NSW, AustraliaBackgroundCancer is a major public health problem worldwide and the leading cause of death in China, with increasing incidence and mortality rates. This study sought to assess socioeconomic-related inequalities in health care use among cancer patients in China and to analyze factors associated with this disparity.MethodsThis study used data collected for the China Health and Retirement Longitudinal Study in 2018. Patients who reported having cancer were included. The annual per capita household expenditure was classified into five groups by the quintile method. We calculated the distribution of actual, need-predicted, and need-standardized health care use across different socioeconomic groups among patients with cancer. The concentration index (CI) was used to evaluate inequalities in health care use. Influencing factors of inequalities were measured with the decomposition method.ResultsA total of 392 people diagnosed with cancer were included in this study. The proportion of cancer patients who utilized outpatient and inpatient services was 23.47% and 40.82%, respectively, and the CIs for actual outpatient and inpatient service use were 0.1419 and 0.1960. The standardized CIs (CI for outpatient visits = 0.1549; CI for inpatient services = 0.1802) were also both positive, indicating that affluent cancer patients used more health services. The annual per capita household expenditure was the greatest factor favoring the better-off, which contributed as much as 78.99% and 83.92% to the inequality in outpatient and inpatient services use, followed by high school education (26.49% for outpatient services) and living in a rural village (34.53% for inpatient services). Urban Employee Basic Medical Insurance exacerbated the inequality in inpatient services (21.97%) while having a negative impact on outpatient visits (−22.19%).ConclusionsThere is a pro-rich inequality in outpatient and inpatient services use among cancer patients in China. A lower socioeconomic status is negatively associated with cancer care use. Hence, more targeted financial protection for poor people would relieve cancer patients of the burden caused by the high cost of cancer care.https://www.frontiersin.org/articles/10.3389/fpubh.2022.942911/fullinequalityhealth care usecancer patientsconcentration indexChina |
| spellingShingle | Huiru Zhang Yu Fu Mingsheng Chen Mingsheng Chen Lei Si Socioeconomic inequality in health care use among cancer patients in China: Evidence from the China health and retirement longitudinal study Frontiers in Public Health inequality health care use cancer patients concentration index China |
| title | Socioeconomic inequality in health care use among cancer patients in China: Evidence from the China health and retirement longitudinal study |
| title_full | Socioeconomic inequality in health care use among cancer patients in China: Evidence from the China health and retirement longitudinal study |
| title_fullStr | Socioeconomic inequality in health care use among cancer patients in China: Evidence from the China health and retirement longitudinal study |
| title_full_unstemmed | Socioeconomic inequality in health care use among cancer patients in China: Evidence from the China health and retirement longitudinal study |
| title_short | Socioeconomic inequality in health care use among cancer patients in China: Evidence from the China health and retirement longitudinal study |
| title_sort | socioeconomic inequality in health care use among cancer patients in china evidence from the china health and retirement longitudinal study |
| topic | inequality health care use cancer patients concentration index China |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.942911/full |
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