Research on the Inequality of Health Care Utilization among Three Social Medical Insurance

doi:10.7664/CHE20171207

Abstract：Objective:To analyze various groups of health services utilization of medical insurance for urban workers,medical insurance for urban residents and the new rural cooperative medical care in China,compare three groups of health service utilization degree of inequality and estimate the inequality decomposition of related factors.Methods:The utilization of health services of 9 836 residents in 6 provinces,16 cities and 31 counties was investigated by field investigation.The concentration index and concentration curve were applied to calculate the health services of provinces,cities and counties to make use of inequality.The relative inequalities and normalization inequalities of the three medical insurance systems were calculated by regression analysis and concentration index decomposition.Results:Taking the per capita household income of residents as a reference,concentration index of residents health service utilization in China were estimated.Based on the regression equation analysis with the control of the factors of economics,age,geogray,etc,the concentration index for urban employee medical insurance was 0.1332,the concentration index for urban resident medical insurance was 0.1225,the concentration index for New Rural Cooperative Medical System was 0.0994.These indexes were all improved after the change.Conclusion:From the inequality reflected by the concentration index,the health service utilization equity for the insured groups in Liaoning was fairly well,while the inequality in Shaanxi was poor.There were inequity gaps of the health services among these three social basic medical insurance group.The inequity of urban employee medical insurance was the largest,followed by the medical insurance for urban residents,the inequity of new rural cooperative medical system was minimum.