Equity Of Health Service Utilization Between Urban And Rural Residents In Jilin Province

Health services utilization fairness refers to through the various available for fair and equal distribution of health resources, make all the people have the same opportunity to access to health services, and there are no differences between their age, sex, region, religion and the social and economic conditions. To guarantee social members fair, accessible and effective to obtain health services in order to achieve health fair is one of the important goals of the pursuit of governments and international organizations in the health field. A large number of studies have shown that the differences of health services utilization between different populations and the unfair phenomenon of long-standing can affect not only the improvement of the health system performance, also pose a threat to residents’ health, and has become an important chal enge in the field of global health. Therefore, to study and draw lessons from foreign scientific measurement method to make an objective evaluation of the health services utilization fairness, find focus of contradictions, can put forward reasonable effective strategies for health policy makers to provide directional guidance.Objectives:To understand the status and influence factors of residents aged 15 and older, to analyzes the un-equity of health services utilization of urban and rural residents and to discuss the main contribution of health services utilization unfair factors, to find the focus of the existing problems and put forward the necessary solutions, to provide information for health administration to formulate targeted regional health planning and health policies and strategies, to lay the theory foundation for comprehensively improving the performance of health system, realizing the whole crowd health fair, guaranteeing the theoretical basis for health.Methods:Data come from the household health interview survey of the Fifth National Health Services Survey in 2013 in Jilin province. Methods of Multilevel stratified random sampling were used, and face to face investigation was also used by the investigators in the house of investigators. SPSS17.0, Stata11.0 and Excel2011 were used to analysis data. Inspection level a = 0.05.Influence factors analysis using person chi-square, centralized equity analysis index, concentration index decomposition and concentration index standardized method. Inspection level is 0.05. Person chi-square was used to analysis the influence factors and concentration index, concentration index decomposition and concentration index standardized were used to analysis the equity.Results: 1. The rate of ill injury and chronic disease prevalence of urban residents were 16.9% and 21.9%, significantly higher than that of the rural residents. Urban and rural hospitalizing rates in disease within two weeks were 3.2%, 5.2%, which were statistical y significant different. Urban and rural hospitalization rates within a year were 3.8% and 3.4%, which were not statistically significant different.2. Age, employment and economic level were the main influencing factors of ill injury within two weeks. Both rural and urban, the outpatient visits of ill injury in the high age group were significantly lower than that of the low age group. From the point of employment, the outpatient visits of ill injury of retired people were relatively low. The outpatient visits of ill injury of patients with low economic level were higher than that of patients with high economic level, especially urban evident difference between the patients.3. Age, employment, economic and education level were the main influencing factors of inpatient visits with patients need to be hospitalized. Both rural and urban, the inpatient visits with patients need to be hospitalized in the high age group were significantly lower than that of the low age group. From the point of employment, the inpatient visits with patients need to be hospitalized of unemployed that need to be hospitalized is relatively low. The inpatient visits of patients need to be hospitalized with high economic and culture level were higher than that of patients with low economic and culture level.4. The analysis results of equity with outpatient service show that the standardized concentration index of the outpatient service using between urban and rural residents in different economic level was-0.1032 and-0.0275 respectively, with leaning to poor. People having the same health services need with low economy level high use more outpatient service.5. The analysis results of equity with inpatient service using show that the standardized concentration index of the inpatient service using between urban and rural residents in different economic level was 0.0855 and 0.1347 respectively, with leaning to rich. People having the same health services need with high economy level high use more inpatient service, and unfairness in rural areas is more serious.Conclusions: 1. The difference of health services utilization between the different social segments of population is the objective existence and cannot be ignored.2. The horizontal unfair index of outpatient service utilization level of urban and rural residents was leaning to poor, and the degree of fairness were good.3. The horizontal unfair index of inpatient service utilization level of urban and rural residents was leaning to rich respectively, and the degree of fairness was poorer. The largest contribution rate to horizontal concentration index of inpatient medical service using was the economic level.4. In order to improve the equity of health care utilization, suggesting that the relevant departments need to improve the quality of primary care, perfecting the medical security system and social assistance to expand the scope of the security level and benefit, to establish suitable for China "Medical support integration" pension model, for realizing target of health equity finally.