The Health Effects of Geographic Accessibility of Rural Medical Services from the Perspective of Equity
Geographic accessibility is an essential aspect of accessibility to healthcare services,which is particularly crucial in underdeveloped and unevenly developed rural areas.Geographic accessibility to healthcare services is a significant factor influencing the equity of access to healthcare opportunities and alleviating health inequalities.This study uses panel data from four waves of the CHARLS survey conducted between 2011 and 2018,employing various methods such as random effects and fixed effects models,as well as instrumental variable method,PSM-DID,and PSM-DDD,to empirically analyze the impact of geographic accessibility to healthcare services on rural residents'health levels and the health effects of integrating rural health insurance schemes.The study yields the following conclusions.First,improving the geographic accessibility of healthcare services enhances rural residents'health levels through the substitution effect and income effect,and this conclusion remains robust even when considering the lag effect and replacing the explanatory variables.Second,more geographic accessibility to healthcare services reinforces the alleviating effect of integrating urban and rural health insurance system on health inequality through a gain effect.Third,the health improvement effect of outpatient accessibility tends to benefit higher-income groups more than low-income groups,whereas improving inpatient accessibility benefits more low-income groups.Fourth,the health improvement effects of geographic accessibility to healthcare services are weaker among the elderly,those living alone,and the farmers in western regions,potentially leading to new health inequalities,i.e.incremental inequalities,which require more targeted supporting measures to promote the evolution of primary healthcare governance from"more equitable opportunities"to"more equitable outcomes".
万方数据
维普
