Residents’ educational attainment and preventive care utilization in China
International Journal of Health Care Quality Assurance
ISSN: 0952-6862
Article publication date: 12 February 2018
Abstract
Purpose
China launched a comprehensive health reform in 2009 to improve healthcare quality. Because preventive care utilization in China has not been frequently discussed, the purpose of this paper is to focus on the association between education level and preventive care before and after the initiation of the reform. Education has been referred to as the best health outcome indicator and China’s educational reform has been progressive, such as the health reform.
Design/methodology/approach
The authors analyzed data from four China Health and Nutrition Surveys (CHNS): 2004 (n=9,617); 2006 (n=9,527); 2009 (n=9,873); and 2011 (n=9,430). Variables were selected based on Andersen’s healthcare utilization model (predisposing, enabling and need factors). Multivariable logistic regression models, odds ratios (ORs) and 95 percent confidence intervals (95 percent CI) were conducted and reported.
Findings
In the adjusted multivariable logistic regression models, the authors found that general education was associated (p<0.05) with access to preventive care in 2004, 2009 and 2011, but not in 2006. Individuals with higher education had higher ORs for utilizing preventive care, compared with lower education (primary school education or none).
Practical implications
Policy implications include providing educational protocols regarding preventive care’s significance to residents educated at lower level schools, especially younger individuals.
Originality/value
To the authors’ knowledge, this is the first comparative assessment on education level and preventive care utilization before and after the implementation of the Chinese health reform.
Keywords
Acknowledgements
The authors would like to thank: Professor William DeJong, Professor of community health sciences at Boston University School of Public Health, for his generous help constructing the statistical models. This research uses data from the China Health and Nutrition Survey (CHNS); National Institute for Nutrition and Health, China Center for Disease Control and Prevention, Carolina Population Center (P2C HD050924, T32 HD007168), the University of North Carolina at Chapel Hill, the NIH (R01-HD30880, DK056350, R24 HD050924, and R01-HD38700); NIH Fogarty International Center (D43 TW009077, D43 TW007709) for financial support and for the CHNS data collection and analysis files from 1989 to 2015; China-Japan Friendship Hospital, Ministry of Health for support for CHNS 2009, Chinese National Human Genome Center at Shanghai; and Beijing Municipal Center for Disease Prevention and Control.
Citation
Lee, Y.-H., Chiang, T. and Liu, C.-T. (2018), "Residents’ educational attainment and preventive care utilization in China", International Journal of Health Care Quality Assurance, Vol. 31 No. 1, pp. 41-51. https://doi.org/10.1108/IJHCQA-01-2017-0001
Publisher
:Emerald Publishing Limited
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