Changes in Socio-economic Status and the Inequality of Healthcare Utilization in China between 2000 and 2011
- 公共卫生－已发表论文 
本文利用CHNS数据从一个全新的角度详细分析了21世纪以来我国居民社会经济地位对医疗服务利用不平等的影响。考虑到医疗消费支出为受限因变量,为了得到一致估计,本文在夏普里值分解之前分别构建了Tobit模型和两部模型,并对结果进行了比较。从总体上来看,我国居民医疗服务利用基尼系数虽有所下降,但始终保持在0.86以上的较高水平,其中社会经济地位是除需要类变量以外最为重要的影响因素,约占总体不平等的15%左右,进一步排序分析表明,收入的相对重要性最大,其后依次为工作状况、教育和职业。从变化趋势来看,社会经济地位的绝对贡献额和相对贡献率均具有波动上升的趋势。因此,减小医疗服务利用不平等的关键是降低社会经济地位差距,特别是收入差距。The objective of this paper is to illustrate and examine the influence of socio-economic status of Chinese residents on the inequality of healthcare utilization by using CHNS data. In order to obtain a consistent estimate and make a comparison between the results,both Tobit model and Two-part model are established.The analysis reveals that the inequality of healthcare utilization in China has declined,but still maintains at a high level of more than 0.86. The socio-economic status is the most important factor except the need variable,which accounts for about 15%.With a further sorting,it can be seen that income is successively followed by work status,education and occupation. From the trend point,both the absolute contribution and the relative rate of socio-economic status have an upward trend with a fluctuation. From a totally new perspective,this study draws on the relationship between the socio-economic status of Chinese residents and the inequality of healthcare utilization,and finds that the key to reduce the inequality of healthcare utilization is to decrease the inequality of the socio-economic status,especially income inequality.