Unmasking unexpected health care inequalities in China using urban big data: Service-rich and service-poor communities

PLoS One. 2022 Feb 10;17(2):e0263577. doi: 10.1371/journal.pone.0263577. eCollection 2022.

Abstract

Geographic accessibility plays a key role in health care inequality but remains insufficiently investigated in China, primarily due to the lack of accurate, broad-coverage data on supply and demand. In this paper, we employ an innovative approach to local supply-and-demand conditions to (1) reveal the status quo of the distribution of health care provision and (2) examine whether individual households from communities with different housing prices can acquire equal and adequate quality health care services within and across 361 cities in China. Our findings support previous conclusions that quality hospitals are concentrated in cities with high administrative rankings and developmental levels. However, after accounting for the population size an "accessible" hospital serves, we discern "pro-poor" inequality in accessibility to care (denoted as GAPSD) and that GAPSD decreases along with increases in administrative rankings of cities and in community ratings. This paper is significant for both research and policy-making. Our approach successfully reveals an "unexpected" pattern of health care inequality that has not been reported before, and our findings provide a nationwide, detailed benchmark that facilitates the assessment of health and urban policies, as well as associated policy-making.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Big Data
  • China
  • Cities / economics
  • Community Health Services / economics
  • Health Services / economics*
  • Healthcare Disparities / economics*
  • Humans
  • Poverty

Grants and funding

He, QS. No. 42001334 National Natural Science Foundation of China https://isisn.nsfc.gov.cn/egrantweb/ The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.