Unmasking unexpected health care inequalities in China using urban big data: Service-rich and service-poor communities

• Published in: PloS one Vol. 17; no. 2; p. e0263577
• Main Authors: Zheng, Linzi, Zhang, Lu, Chen, Ke, He, Qingsong
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 10.02.2022; Public Library of Science (PLoS)
• Subjects: Accessibility; Analysis; Big Data; Biology and Life Sciences; China; Cities; Cities - economics; Community Health Services - economics; Demographic aspects; Earth Sciences; Engineering and Technology; Family planning; Health aspects; Health care; Health care disparities; Health care policy; Health care rationing; Health disparities; Health services; Health Services - economics; Healthcare Disparities - economics; Hospitals; Households; Housing; Humans; Inequality; Inventory; Jurisdiction; Low income areas; Medicine and Health Sciences; People and Places; Policy making; Population number; Poverty; Primary care; Public administration; Quality of care; Ratings & rankings; Social aspects; Social Sciences; Supply & demand; Supply and demand; Urban areas; Urban policy; China; Cities
• DOI: 10.1371/journal.pone.0263577
• ISSN: 1932-6203

Geographic accessibility plays a key role in health care inequality but remains insufficiently investigated in China, primarily due to the lack of accurate, broad-coverage data on supply and demand. In this paper, we employ an innovative approach to local supply-and-demand conditions to (1) reveal the status quo of the distribution of health care provision and (2) examine whether individual households from communities with different housing prices can acquire equal and adequate quality health care services within and across 361 cities in China. Our findings support previous conclusions that quality hospitals are concentrated in cities with high administrative rankings and developmental levels. However, after accounting for the population size an "accessible" hospital serves, we discern "pro-poor" inequality in accessibility to care (denoted as GAPSD) and that GAPSD decreases along with increases in administrative rankings of cities and in community ratings. This paper is significant for both research and policy-making. Our approach successfully reveals an "unexpected" pattern of health care inequality that has not been reported before, and our findings provide a nationwide, detailed benchmark that facilitates the assessment of health and urban policies, as well as associated policy-making.