2023-09-28 14:46:10 +00:00
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abstract: 'Non-communicable diseases (NCDs) are a large and rapidly-growing problem
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in China and other middle-income countries. Clinical treatment of NCDs
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is long-term and expensive, so it may present particular problems for
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equality and horizontal equity (equal treatment for equal need) in
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access to health care, although little is known about this at present in
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low-and middle-income countries. To address this gap, and inform policy
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for a substantial proportion of the global population, we examined
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inequality and inequity in general health care utilization (doctor
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consultations and hospital admissions) and in treatment of chronic
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conditions (hypertension, hyperglycaemia and dyslipidaemia), in 30 499
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Chinese adults aged >= 50 years from one of China''s richest provinces,
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using the Guangzhou Biobank Cohort Study (2003-2008).
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We used concentration indices to test for inequality and inequity in
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utilization by household income per head. Inequality was decomposed to
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show the contributions of income, indicators of `need for health care''
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(age, sex, self-rated health, coronary heart disease risk and chronic
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obstructive pulmonary disease) and non-need factors (education,
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occupation, out-of-pocket health care payments and health insurance).
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We found inequality and inequity in treatment of chronic conditions but
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not in general health care utilization. Using more objective and
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specific measures of `need for health care'' increased estimates of
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inequity for treatment of chronic conditions. Income and non-need
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factors (especially health insurance, education and occupation) made the
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largest contributions to inequality. Further work is needed on why
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access to treatment for chronic conditions in China is restricted for
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those on low incomes and how these inequities can be mitigated.'
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affiliation: 'Schooling, CM (Corresponding Author), Univ Hong Kong, Sch Publ Hlth,
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Li Ka Shing Fac Med, 21 Sassoon Rd, Pokfulam, Hong Kong, Peoples R China.
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Elwell-Sutton, Timothy M.; Lam, Tai H.; Leung, Gabriel M.; Schooling, C. M., Univ
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Hong Kong, Sch Publ Hlth, Li Ka Shing Fac Med, Pokfulam, Hong Kong, Peoples R China.
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Jiang, Chao Qiang; Zhang, Wei Sen, Guangzhou 12 Hosp, Guangzhou, Guangdong, Peoples
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R China.
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Cheng, Kar Keung, Univ Birmingham, Birmingham, W Midlands, England.'
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author: Elwell-Sutton, Timothy M. and Jiang, Chao Qiang and Zhang, Wei Sen and Cheng,
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Kar Keung and Lam, Tai H. and Leung, Gabriel M. and Schooling, C. M.
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author-email: cms1@hkucc.hku.hk
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author_list:
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- family: Elwell-Sutton
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given: Timothy M.
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- family: Jiang
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given: Chao Qiang
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- family: Zhang
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given: Wei Sen
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- family: Cheng
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given: Kar Keung
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- family: Lam
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given: Tai H.
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- family: Leung
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given: Gabriel M.
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- family: Schooling
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given: C. M.
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da: '2023-09-28'
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doi: 10.1093/heapol/czs077
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eissn: 1460-2237
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files: []
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issn: 0268-1080
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journal: HEALTH POLICY AND PLANNING
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keywords: Inequity; inequality; chronic illness; access to care; China
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keywords-plus: 'CHRONIC DISEASES; RISK-FACTORS; HONG-KONG; EQUITY; POPULATION; INCOME;
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SERVICES; PREVALENCE; PREVENTION; MANAGEMENT'
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language: English
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month: AUG
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number: '5'
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number-of-cited-references: '54'
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orcid-numbers: 'Cheng, Kar/0000-0002-1516-1857
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Elwell-Sutton, Timothy/0000-0003-4950-726X
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Lam, Tai Hing/0000-0002-2033-9971
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Schooling, Mary/0000-0001-9933-5887
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Leung, Gabriel/0000-0002-2503-6283'
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pages: 467-479
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papis_id: 1497e8ea8b8012dbaee5f8ec13559d38
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ref: Elwellsutton2013inequalityinequity
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researcherid-numbers: 'Leung, Gabriel Matthew/C-4336-2009
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Cheng, Kar/AAL-8899-2021
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Lam, Tai Hing/C-4317-2009
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'
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times-cited: '39'
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title: 'Inequality and inequity in access to health care and treatment for chronic
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conditions in China: the Guangzhou Biobank Cohort Study'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000323444700004
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usage-count-last-180-days: '1'
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usage-count-since-2013: '48'
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volume: '28'
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web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
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year: '2013'
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