Inequality of access to health care among the urban elderly in northwestern China

Objective: The purpose of this study was to examine inequalities of access to health care among the urban elderly in northwestern China. Methods: 4441 seniors (over 60 years of age) were drawn from a cross-sectional study conducted in three northwestern Chinese cities. The effects of these factors on the use of health care services (visits to physician and hospitalizations) were estimated using multiple binomial regressions. Results: Overall, 7.6% of the population studied had visited a physician during the past 4 weeks, 10.1% had used inpatient care during the past year, and 7.6% did not use inpatient services despite being referred by doctors for hospital admission during the previous year. Both visits to a physician and non-hospitalization were independently associated with the place of residence and household per capita income; the use of inpatient care services was significantly lower among those with less education, those with lower household per capita income and those without health insurance coverage. Women tended to make more use of outpatient services, but spent less time and money in hospital than men. Conclusion: Our findings indicate a significant inequality of access to health care services among urban seniors in northwestern China. More appropriate health care policies should be developed to achieve the goal of greater equality of access to health care services for all. (C) 2009 Elsevier Ireland Ltd. All rights reserved.