Elasticity of the demand for health care services in China: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

ZHENG Xue , LIU Guoxiang , JI Men , LIU Xiwei , FANG Zhiyu ,  ZHANG Xin

School of Public Health, Harbin Medical University, Harbin, 150081, P.R.China;

Corresponding author：

ZHANG Xin, Email: zhangxinzhx0801@126.com

Keywords：

Demand for health care services; Price elasticity; Income elasticity; China

DOI：

10.7507/1672-2531.201606037

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Objective To investigate the elasticity of demand for health care services in China, and to provide suggestions for further studies. Methods Databases including PubMed, The Cochrane Library (Issue 10, 2015), EMbase, CNKI, VIP and WanFang Data were searched from inception to December 2015 to collect studies about price elasticity or income elasticity of demand for health care services. Literatures were screened and related information was independently extracted by two reviewers. Then qualitative approaches were applied to describe the elasticity. Results A total of 31 studies were included. Estimates of the own-price elasticity of demand for health care services ranged from –2.520 to 2.944 in 25 studies; 2 studies estimated cross-price elasticity between outpatient and inpatient service and one study estimated cross-price elasticity between different levels of inpatient services and all estimates were positive; Estimates of the income elasticity ranged from –0.020 to 2.480 in 28 studies. Demand for inpatient services was more income sensitive than the demand for outpatient services and urban citizens were more sensitive to income than their rural counterparts. Conclusion Health service is insensitive to price and belongs to necessity; inpatient service and outpatient service are substitutes for each other and different levels of inpatient services are substitutes for each other; government are supposed to tackle with the unbalanced increase of the demand of outpatient and inpatient services along with the increase of income to guide rational health-seeking behaviors.

Citation： ZHENG Xue, LIU Guoxiang, JI Men, LIU Xiwei, FANG Zhiyu, ZHANG Xin. Elasticity of the demand for health care services in China: a systematic review. Chinese Journal of Evidence-Based Medicine, 2017, 17(5): 564-572. doi: 10.7507/1672-2531.201606037 Copy

1.	孟庆跃. 卫生经济学. 北京: 人民卫生出版社, 2013.
2.	皇甫荣. 商品销售中价格需求弹性的影响因素及应用办法. 中国商贸, 2010(25): 245-246.
3.	Liu S, Chollet D. Price and income elasticity of the demand for health insurance and health care services. Mathematica Policy Research, 2006.
4.	杨静, 高建民, 郭海涛, 等. 医疗卫生服务需求弹性国内外研究进展. 现代预防医学, 2008, 35(6): 1084-1085.
5.	Grossman M. The Demand for Health: A Theoretical and Empirical Investigation. New York: Columbia University Press, 1972.
6.	Newhouse JP, Phelps CE. Price and income elasticities for medical care services. RAND Corporation, 1974.
7.	Manning W G, Newhouse J P, Duan N, et al. Health insurance and the demand for medical care: evidence from a randomized experiment. Am Econ Rev, 1987, 77(3): 251-277.
8.	林子华, 顾杏元. 村级卫生服务需求影响因素的弹性系数研究. 中国初级卫生保健, 1990(9): 5-8.
9.	刘丽娜, 徐凌中, 王兴州, 等. 我国城乡门诊医疗服务需求弹性研究. 中国卫生经济, 2006, 25(7): 34-36.
10.	Brown PH, Theoharides C. Health-seeking behavior and hospital choice in China's New Cooperative Medical System. Health Econ, 2009, 18(S2): S47-S64.
11.	朱航宇, 顾海. 用 ELES 模型分析城镇居民药品需求弹性. 中国药房, 2006, 17(9): 651-653.
12.	杨学来, 徐凌中, 王斌, 等. 东营地区居民慢性病医疗服务需求弹性研究. 中华医院管理杂志, 2005, 21(7): 472-474.
13.	龚时薇, 张亮. 我国常见病与罕见病住院患者医疗服务需求特点分析. 中国卫生经济, 2011, 30(2): 39-41.
14.	Zhou Z, Gao J, Xue Q, et al. Effects of Rural Mutual Health Care on outpatient service utilization in Chinese village medical institutions: evidence from panel data. Health Econ, 2009, 18(Supplement 2): S129-136.
15.	周忠良, 苏延芳, 高建民, 等. 农村居民卫生服务需求弹性研究. 中国卫生经济, 2011, 30(12): 14-16.
16.	陈心广, 饶克勤, 魏晟. 中国农村基本医疗服务需求弹性经济学模型研究. 中国卫生事业管理, 1996(3): 150-153.
17.	陈心广, 魏晟, 饶克勤. 中国城市基本医疗服务需求弹性经济学模型研究. 中国卫生经济, 1996(2): 55-57.
18.	王谦, 孟庆跃, 刘兴柱, 等. 山东省麻风现症病人卫生服务需求弹性研究. 中国卫生事业管理, 1997(11): 612-613.
19.	龚向光, 胡善联. 贫困地区农民合作医疗支付能力研究. 中国卫生经济, 1998(10): 5-7.
20.	Mocan HN, Tekin E, Zax JS. The demand for medical care in urban China. World Dev, 2004, 32(2): 289-304.
21.	梁维萍, 郑建中, 韩颖, 等. 农村居民收入与医疗服务需求及其弹性研究. 中国农村卫生事业管理, 2005, 25(10): 15-17.
22.	薛秦香, 高建民, 颜虹, 等. 陕西省农民卫生支付能力研究. 卫生经济研究, 2006(2): 24-26.
23.	封进, 秦蓓. 中国农村医疗消费行为变化及其政策含义. 世界经济文汇, 2006(1): 75-88.
24.	Qian D, Pong R W, Yin A, et al. Determinants of health care demand in poor, rural China: the case of Gansu Province.. Health Policy Plan, 2009, 24(5): 324-334.
25.	Zhou Z, Su Y, Gao J, et al. New estimates of elasticity of demand for healthcare in rural China. Health Policy, 2011, 103(2-3): 255-265.
26.	Liu J, Shi L, Khan M, et al. Trends of out-of-pocket expenditure for influenza in China health and nutrition survey during 1989–2006. Int J Public Health, 2012, 57(57): 193-198.
27.	谭涛, 张燕媛, 何军. 中国农村居民家庭医疗消费支出的影响因素及弹性分析. 上海财经大学学报: 哲学社会科学版, 2014, 16(3): 63-69.
28.	王谦, 肖永富, 魏继炳, 等. 四川省血吸虫病查治卫生服务需求弹性研究及其对血防筹资的意义. 中国病原生物学杂志, 2001, 14(2): 124-126.
29.	石洪兴, 吕军, 谢一萍, 等. 中国乡级卫生机构卫生服务需求弹性的研究. 北京大学学报: 医学版, 2010, 42(3): 264-269.
30.	徐光毅, 邱小丹. 深港门诊医疗服务的需求弹性比较研究. 中国管理科学学术年会. 2011.
31.	孟雪晖, 饶东平, 张秋, 等. 农村参合高血压患者对各级医疗机构住院服务的需求弹性分析. 中国卫生统计, 2013, 30(2): 170-172.
32.	朱宏. 我国药品需求弹性的研究. 西部药学, 2004, 15(11): 145-147.
33.	孔凡玲, 赵增科, 孟庆跃, 等. 山东省医疗服务需求影响因素的导数和点弹性分析. 预防医学论坛, 2005, 11(1): 99-101.
34.	徐伟. 从需求弹性实证的角度谈我国医疗卫生改革. 中国卫生经济, 2006, 25(11): 19-22.
35.	Chow GC. An economic analysis of health care in China. Investing in Human Capital for Economic Development in China, 2006: 183.
36.	刘旭宁. 转型时期我国城乡居民医疗保健消费需求的实证分析. 产业经济评论: 山东大学, 2010, 09(1): 104-119.
37.	刘晓红. 中国农村居民医疗保健消费需求实证分析. 中国发展, 2011, 11(3): 46-52.
38.	Luo D, Song B. Analysis of the income elasticity of the consumer demand of Chinese rural residents and prediction of its trend. Kybernetes, 2012, 2(2): 655-663(9).
39.	张研, 唐文熙, 孙晓伟, 等. 居民自由就医对我国卫生服务体系整合的影响. 中国卫生事业管理, 2014, 31(9): 678-680.
40.	程怀志, 郭斌, 谢欣, 等. 我国慢性病患病率的社会人口学分析. 医学与社会, 2014, 27(3): 4-6.
41.	何静, 游毅, 洪宝林, 等. 中国卫生服务需求实证研究现状. 社区医学杂志, 2013, 11(11): 27-29.
42.	杨静, 高建民, 郭海涛, 等. 医疗卫生服务需求弹性国内外研究进展. 现代预防医学, 2008, 35(6): 1084-1085.

1. 孟庆跃. 卫生经济学. 北京: 人民卫生出版社, 2013.
2. 皇甫荣. 商品销售中价格需求弹性的影响因素及应用办法. 中国商贸, 2010(25): 245-246.
3. Liu S, Chollet D. Price and income elasticity of the demand for health insurance and health care services. Mathematica Policy Research, 2006.
4. 杨静, 高建民, 郭海涛, 等. 医疗卫生服务需求弹性国内外研究进展. 现代预防医学, 2008, 35(6): 1084-1085.
5. Grossman M. The Demand for Health: A Theoretical and Empirical Investigation. New York: Columbia University Press, 1972.
6. Newhouse JP, Phelps CE. Price and income elasticities for medical care services. RAND Corporation, 1974.
7. Manning W G, Newhouse J P, Duan N, et al. Health insurance and the demand for medical care: evidence from a randomized experiment. Am Econ Rev, 1987, 77(3): 251-277.
8. 林子华, 顾杏元. 村级卫生服务需求影响因素的弹性系数研究. 中国初级卫生保健, 1990(9): 5-8.
9. 刘丽娜, 徐凌中, 王兴州, 等. 我国城乡门诊医疗服务需求弹性研究. 中国卫生经济, 2006, 25(7): 34-36.
10. Brown PH, Theoharides C. Health-seeking behavior and hospital choice in China's New Cooperative Medical System. Health Econ, 2009, 18(S2): S47-S64.
11. 朱航宇, 顾海. 用 ELES 模型分析城镇居民药品需求弹性. 中国药房, 2006, 17(9): 651-653.
12. 杨学来, 徐凌中, 王斌, 等. 东营地区居民慢性病医疗服务需求弹性研究. 中华医院管理杂志, 2005, 21(7): 472-474.
13. 龚时薇, 张亮. 我国常见病与罕见病住院患者医疗服务需求特点分析. 中国卫生经济, 2011, 30(2): 39-41.
14. Zhou Z, Gao J, Xue Q, et al. Effects of Rural Mutual Health Care on outpatient service utilization in Chinese village medical institutions: evidence from panel data. Health Econ, 2009, 18(Supplement 2): S129-136.
15. 周忠良, 苏延芳, 高建民, 等. 农村居民卫生服务需求弹性研究. 中国卫生经济, 2011, 30(12): 14-16.
16. 陈心广, 饶克勤, 魏晟. 中国农村基本医疗服务需求弹性经济学模型研究. 中国卫生事业管理, 1996(3): 150-153.
17. 陈心广, 魏晟, 饶克勤. 中国城市基本医疗服务需求弹性经济学模型研究. 中国卫生经济, 1996(2): 55-57.
18. 王谦, 孟庆跃, 刘兴柱, 等. 山东省麻风现症病人卫生服务需求弹性研究. 中国卫生事业管理, 1997(11): 612-613.
19. 龚向光, 胡善联. 贫困地区农民合作医疗支付能力研究. 中国卫生经济, 1998(10): 5-7.
20. Mocan HN, Tekin E, Zax JS. The demand for medical care in urban China. World Dev, 2004, 32(2): 289-304.
21. 梁维萍, 郑建中, 韩颖, 等. 农村居民收入与医疗服务需求及其弹性研究. 中国农村卫生事业管理, 2005, 25(10): 15-17.
22. 薛秦香, 高建民, 颜虹, 等. 陕西省农民卫生支付能力研究. 卫生经济研究, 2006(2): 24-26.
23. 封进, 秦蓓. 中国农村医疗消费行为变化及其政策含义. 世界经济文汇, 2006(1): 75-88.
24. Qian D, Pong R W, Yin A, et al. Determinants of health care demand in poor, rural China: the case of Gansu Province.. Health Policy Plan, 2009, 24(5): 324-334.
25. Zhou Z, Su Y, Gao J, et al. New estimates of elasticity of demand for healthcare in rural China. Health Policy, 2011, 103(2-3): 255-265.
26. Liu J, Shi L, Khan M, et al. Trends of out-of-pocket expenditure for influenza in China health and nutrition survey during 1989–2006. Int J Public Health, 2012, 57(57): 193-198.
27. 谭涛, 张燕媛, 何军. 中国农村居民家庭医疗消费支出的影响因素及弹性分析. 上海财经大学学报: 哲学社会科学版, 2014, 16(3): 63-69.
28. 王谦, 肖永富, 魏继炳, 等. 四川省血吸虫病查治卫生服务需求弹性研究及其对血防筹资的意义. 中国病原生物学杂志, 2001, 14(2): 124-126.
29. 石洪兴, 吕军, 谢一萍, 等. 中国乡级卫生机构卫生服务需求弹性的研究. 北京大学学报: 医学版, 2010, 42(3): 264-269.
30. 徐光毅, 邱小丹. 深港门诊医疗服务的需求弹性比较研究. 中国管理科学学术年会. 2011.
31. 孟雪晖, 饶东平, 张秋, 等. 农村参合高血压患者对各级医疗机构住院服务的需求弹性分析. 中国卫生统计, 2013, 30(2): 170-172.
32. 朱宏. 我国药品需求弹性的研究. 西部药学, 2004, 15(11): 145-147.
33. 孔凡玲, 赵增科, 孟庆跃, 等. 山东省医疗服务需求影响因素的导数和点弹性分析. 预防医学论坛, 2005, 11(1): 99-101.
34. 徐伟. 从需求弹性实证的角度谈我国医疗卫生改革. 中国卫生经济, 2006, 25(11): 19-22.
35. Chow GC. An economic analysis of health care in China. Investing in Human Capital for Economic Development in China, 2006: 183.
36. 刘旭宁. 转型时期我国城乡居民医疗保健消费需求的实证分析. 产业经济评论: 山东大学, 2010, 09(1): 104-119.
37. 刘晓红. 中国农村居民医疗保健消费需求实证分析. 中国发展, 2011, 11(3): 46-52.
38. Luo D, Song B. Analysis of the income elasticity of the consumer demand of Chinese rural residents and prediction of its trend. Kybernetes, 2012, 2(2): 655-663(9).
39. 张研, 唐文熙, 孙晓伟, 等. 居民自由就医对我国卫生服务体系整合的影响. 中国卫生事业管理, 2014, 31(9): 678-680.
40. 程怀志, 郭斌, 谢欣, 等. 我国慢性病患病率的社会人口学分析. 医学与社会, 2014, 27(3): 4-6.
41. 何静, 游毅, 洪宝林, 等. 中国卫生服务需求实证研究现状. 社区医学杂志, 2013, 11(11): 27-29.
42. 杨静, 高建民, 郭海涛, 等. 医疗卫生服务需求弹性国内外研究进展. 现代预防医学, 2008, 35(6): 1084-1085.

Chinese Journal of Evidence-Based Medicine

Elasticity of the demand for health care services in China: a systematic review

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