Enhancing Health Equity in China: The Interplay of Public Health Infrastructure, Service Utilization, and Health Insurance

Xiaoyan Chen, Yajiao Chen (), Beibei Qin and Qinghua He
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Xiaoyan Chen: School of Urban Economics and Management, Beijing University of Civil Engineering and Architecture, Beijing 100044, China
Yajiao Chen: School of Economics and Management, Tongji University, Shanghai 200092, China
Beibei Qin: School of Urban Economics and Management, Beijing University of Civil Engineering and Architecture, Beijing 100044, China
Qinghua He: School of Economics and Management, Tongji University, Shanghai 200092, China

Sustainability, 2025, vol. 17, issue 11, 1-21

Abstract: The COVID-19 pandemic exposed significant deficiencies in global health emergency preparedness, highlighting the critical importance of health equity. This study investigates the role of public health infrastructure in promoting health equity, utilizing data from 31 provincial regions in China. The analysis examines the mediating role of medical service utilization (hospitalization and outpatient services) and the moderating effect of health insurance. The findings indicate that public health infrastructure is significantly associated with health equity. Medical service utilization partially mediates this relationship, with health insurance further moderating the positive impact of hospitalization utilization on health equity, though not for outpatient services. Regional analysis reveals heterogeneity, with public health infrastructure exerting a significant effect on health equity in the central–western regions but not in the eastern region. This research underscores the importance of accessible public health infrastructure and comprehensive health insurance in eliminating health disparities, providing valuable insights for policymaking aimed at fostering health equity.

Keywords: public health infrastructure; health equity; medical service utilization; health insurance (search for similar items in EconPapers)
JEL-codes: O13 Q Q0 Q2 Q3 Q5 Q56 (search for similar items in EconPapers)
Date: 2025
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