Assessing Income-Related Health Inequality and Horizontal Inequity in China

Zhongliang Zhou, Yu Fang, Zhiying Zhou, Dan Li, Dan Wang, Yanli Li, Li Lu, Jianmin Gao and Gang Chen ()
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Zhongliang Zhou: Xi’an Jiaotong University
Yu Fang: Xi’an Jiaotong University
Zhiying Zhou: Xi’an Jiaotong University
Dan Li: Xi’an Jiaotong University
Dan Wang: Xi’an Jiaotong University
Yanli Li: Xi’an Jiaotong University
Li Lu: Xi’an Jiaotong University
Jianmin Gao: Xi’an Jiaotong University

Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, 2017, vol. 132, issue 1, No 12, 256 pages

Abstract: Abstract The study aims to investigate both income-related health inequality and horizontal equity in urban and rural China. The 4th and 5th National Health Services Survey, and extended samples in Shaanxi Province surveyed in 2008 and 2013, were analysed. Health outcome was measured using the EQ-5D-3L utility, scored by the Chinese-specific tariff. The concentration index was calculated to measure the degree of income-related health inequality and was further decomposed to study the strength of different contributing factors to explain health inequality. The horizontal inequity was further measured based on the decomposition results. The final study sample consists of 15,505 respondents in 2008 and 48,808 respondents in 2013. Descriptive analysis shows that compared to 2008, respondents in both urban and rural China reported worse HRQoL in 2013. There was a pro-rich inequality of HRQoL in both urban and rural China. Controlling for demographic factors, the pro-rich inequity of HRQoL remains. Economic and educational statuses are found to be two key factors explaining the pro-rich inequity. The establishment of basic medical insurance has shown a mixed effect on reducing health inequality. Strategies to reduce the inequality of residents’ economic and educational status, through further implementing the poverty reduction policies, should be prioritised by the local government.

Keywords: Health inequity; Horizontal inequity; Health-related quality of life; EQ-5D; China (search for similar items in EconPapers)
Date: 2017
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DOI: 10.1007/s11205-015-1221-1

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