机构:[1]The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, 111 Dade Road, Guangzhou 510120, China.大德路总院广东省中医院[2]Guangzhou University of Chinese Medicine, Guangzhou 510405, China.深圳市中医院深圳医学信息中心[3]Hunan Provincial Maternal and Child Health Care Hospital, #53 Xiangchun Road, Changsha 410008, China
Background: Inequalities in demographic, socio-economic and health status for China labor force place them at greater health risks, and marginalized them in the utilization of healthcare services. This paper identifies the inequalities which limit the utilization of health services among China labor force, and provides a reference point for health policy. Methods: Data were collected from 23,505 participants aged 15 to 65, from the 2014 China Labor Force Dynamic Survey (a nationwide cross-sectional survey covering 29 provinces with a multi-stage cluster, and stratified, probability sampling strategy) conducted by Sun Yat-sen University. Logistic regression models were used to study the effects of demographic (age, gender, marital status, type of hukou and migration status), socio-economic (education, social class and insurance) and health status (self-perceived general health and several chronic illnesses) variables on the utilization of health services (two-week visiting and hospitalization during the past 12 months). Goodness of fit was assessed using Hosmer-Lemeshow test. Discrimination ability was assessed based on the area under the receiver operating curve (AUC). Results: Migrants with more than 1 (OR 2.80, 95% CI 1.01 similar to 7.82) or none chronic illnesses (OR 1.26, 95% CI 1.01 similar to 7.82) are more likely to be two week visiting to the clinic than non-migrants; migrants with none chronic illnesses (OR 0.61, 95% CI 0.45 similar to 0.82) are less likely to be in hospitalization during the past 12 months than non-migrants. Female, elder, hukou of non-agriculture, higher education level, higher social class, purchasing more insurance and poorer selfperceived health were predictors for more utilization of health service. More insurance benefited more two-week visiting (OR 1.12, 95% CI 1.06 similar to 1.17) and hospitalization during the past 12 months (OR 1.12, 95% CI 1.07 similar to 1.18) for individuals with none chronic illness but not >= 1 chronic illnesses. All models achieved good calibration (Hosmer-Lemeshow test's P range of 0.258-0.987) and discrimination (AUC range of 0.626-0.725). Conclusions: This study has shown that there are inequalities of demographic, socio-economic and health status in the utilization of health services for China labor force. Prudent health policy with equitable utilization of health services eliminating mentioned inequalities should be a priority in shaping China's healthcare system reform.
基金:
China Postdoctoral Science FoundationChina Postdoctoral Science Foundation [2015M580712]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81603494]; Guangdong Natural Science FoundationNational Natural Science Foundation of Guangdong Province [2016A030310290]; TCM Science and Technology Project of Guangdong Provincial Hospital of Chinese Medicine [YN2015QN20]
第一作者机构:[1]The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, 111 Dade Road, Guangzhou 510120, China.
通讯作者:
推荐引用方式(GB/T 7714):
Lu Liming,Zeng Jingchun,Zeng Zhi.What limits the utilization of health services among china labor force? analysis of inequalities in demographic, socio-economic and health status[J].INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH.2017,16:doi:10.1186/s12939-017-0523-0.
APA:
Lu, Liming,Zeng, Jingchun&Zeng, Zhi.(2017).What limits the utilization of health services among china labor force? analysis of inequalities in demographic, socio-economic and health status.INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH,16,
MLA:
Lu, Liming,et al."What limits the utilization of health services among china labor force? analysis of inequalities in demographic, socio-economic and health status".INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH 16.(2017)