An Equity Analysis of Health Examination Service Utilization by Women From Underdeveloped Areas in Western China

PLoS One. 2017 Oct 24;12(10):e0186837. doi: 10.1371/journal.pone.0186837. eCollection 2017.

Abstract

Objective: This study sought to examine the sources of inequity in health examination service utilization by women from underdeveloped areas in western China.

Methods: Based on data from the 5th National Health Service Survey in Shaanxi province, women's utilization of health examination services was examined according to gynecological, cervical smear, and breast examination rates. The equity of health examination service utilization by 15- to 64-year-old women and the factors contributing to inequity were determined using the health concentration index, decomposition of the concentration index, and the horizontal inequity index.

Results: The examination rates for gynecological, cervical smear, and breast exams for 15- to 64-year-old women in Shaanxi province were 40.61%, 27.08%, and 24.59%, respectively. The horizontal inequity indices of gynecological, cervical smear, and breast examination rates were 0.0480, 0.0423, and 0.0764, respectively, and each examination rate was higher for wealthy individuals. The contribution rates of economic status to the inequalities in gynecological, cervical smear, and breast examination rates were 65.80%, 74.31%, and 56.49%, respectively. The contribution rates of educational status to the inequalities in gynecological, cervical smear, and breast examination rates were 21.01%, 14.83% and 30.00%, respectively. The contribution rates of age to the inequalities in gynecological, cervical smear, and breast examination rates were 25.77%, 26.55%, and 18.40%, respectively.

Conclusions: Women's health examination rates differed between populations with different socio-demographic characteristics. There is pro-wealth inequality in each examination rate. This study found that financial status, age, and education level were the main reasons for the unequal utilization of health examination services.

MeSH terms

  • Adolescent
  • Adult
  • China
  • Female
  • Healthcare Disparities
  • Humans
  • Medically Underserved Area*
  • Middle Aged
  • Papanicolaou Test
  • Physical Examination*
  • Women's Health Services / statistics & numerical data*
  • Young Adult

Grant support

This study is supported by China Social Science Foundation. Serial number is 12BJY143. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.