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Who does not see a doctor when sick in contemporary china? exploring urban/rural difference in doctor visit rate and the potential reasons

Senhu Wang

Purpose: Durable and significant urban/rural difference in doctor visit rate has received increasing attention and is thought to exacerbate urban/rural health disparity. In response, the New Rural Cooperative Medical System (NRCMS) has been implemented in 2003 to provide rural residents affordable medical services and improve their doctor visit rate. This article is the first study in China that used nationally representative survey data to compare urban/ rural difference in doctor visit rate and explore its potential reasons after the implementation of NRCMS. Methods: Based on 2010 China General Social Survey (CGSS), this study used logistical regression models to predict the average marginal effects of not seeing a doctor from 1,333 rural residents and 1,568 urban residents. Results: The results show that there is no significant difference in doctor visit rate between urban and rural residents. Nevertheless, ‘high medical costs’, ‘not necessary’, ‘poor transportation’, ‘the distance of the hospital’ and ‘do not like visiting a doctor’ are still important reasons for sick rural residents not seeing a doctor. In contrast, ‘high medical costs’ and ‘long waiting time’ are main reasons for the urban residents. Conclusion: While urban/rural difference in doctor visit rate has been eliminated, the different reasons of not seeing a doctor for urban and rural residents highlight the need of the government to pay attention to the diverse health demands and obstacles to the access to medical services during the process of design and implementation of public health policies.