An Equity Study On Outpatient Services Utilization Of Hypertensive Patients From Multicenter

ObjectiveAnalyze the inequity of hypertensive patients'(HPs')outpatient service utilization in different ages,sexes,history of hypertension,regional distribution,employment status and medical insurance participation,determine the factors affecting equity,calculate the contribution value and contribution rate of the factors,and sort out the main contributing factors according to the importance,and aim at the ranking results.To provide policy recommendations for improving the equity of health services in HPs.MethodsThrough literature analysis,collect relevant literatures about Concentration Index(CI)and its decomposition,as well as the health service utilization of the HPs.By descriptive analysis and statistical inference,analyze HPs characteristics.CI and its decomposition method are employed to access inequity in outpatient utilization by HPs,analyze the factors that affect the fairness,calculate the elastic coefficient,contribution value and contribution rate of the influencing factors,and aim at the ranking results.ResultsThe study is included in 28 sub central communities from 14 provinces,and 8670 HPs aged 15 and above are studied.The outpatient rate within two weeks in the whole sample HPs is 6.9%.The overall CI for HPs is 0.2378,the horizontal utilization(HI)is 0.2360.The CI is positive,that is,HPs with higher income level use more outpatient services.The HI of HPs aged 15?44,45?54,55?64,65 and above are 0.2707,0.1720,0.2900 and 0.1742 respectively.All age groups have different levels of pro-rich inequity,and the level of inequality in the age group of 55?64 is the highest.The HI of outpatient service for employed,retired,unemployed HPs are 0.1994,0.1798 and 0.0614 respectively.All of the HPs' outpatient service utilization in each employment state has different degree of pro-rich inequality,and the level of the employed HPs is the highest.In the eastern,middle and western regions,the HI of the outpatient service for HPs is 0.0706,-0.0671 and-0.3406 respectively.The eastern region is positive,that is,there is pro-rich inequity.The central and western regions are negative,that is,there is pro-poor inequity.The HI of outpatient service utilization by Urban Employee Basic Medical Insurance(UEBMI),Urban Residents Basic Medical Insurance(URBMI)and New Rural Cooperative Medical System(NRCMS)samples are 0.1890,0.0219 and 0.1215 respectively.Under the three social medical insurance system,the outpatient service utilization of all the samples have different degrees of pro-rich inequity.Conclusions? There are inequity in outpatient services utilization of HPs.In the region,there are different levels of pro-rich inequity in the central and western regions,and the eastern region is pro-rich inequity.The CI of the HPs in different age,sex,history of hypertension,employment status and medical insurance participation is positive,that is,the pro-rich inequity.?The economic status is the most important factor aon outpatient utilization in HPs.Medical insurance is an important factor.?Influence factor of different regions and different medical insurance differed for some degree.