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Table 4 Impact of health insurance and health workforce on choice of healthcare providers before and after China’s health system reform

From: Synergy of policies to strengthen primary care: evidence from a national repeated cross-sectional study

Outpatient choice of healthcare providers (reference group is village/community health stations) Before China’s health system reform (RRR) After China’s health system reform (RRR)
Township/
community health centers
County hospitals Municipal or higher-level hospitals Township/
community health centers
County hospitals Municipal or higher-level hospitals
ARR at PHC institutions 1.44
(0.96, 2.16)
0.28***
(0.18, 0.44)
0.18***
(0.10, 0.31)
1.76 ***
(1.04, 2.74)
1.07
(0.80, 1.44)
0.98
(0.73, 1.32)
ARR at county hospitals 1.31
(0.71, 2.39)
1.68
(0.90, 3.15)
2.92***
(1.51, 5.66)
1.44*
(1.00, 2.08)
1.72***
(1.20, 2.45)
1.87***
(1.27, 2.74)
Physicians density at PHC institutions 1.23***
(1.15, 1.32)
0.43***
(0.30, 0.61)
0.76
(0.43, 1.33)
1.34
(0.80, 2.24)
0.95***
(0.91, 0.99)
0.98
(0.95, 1.02)
Physicians density at county hospitals 1.02
(0.98, 1.06)
1.38***
(1.29, 1.48)
1.45 ***
(1.33, 1.58)
0.91***
(0.89, 0.94)
0.98
(0.95, 1.01)
0.99
(0.96, 1.02)
Inpatient choice of healthcare providers (reference group is township/community healthcare centers) County
hospitals
Municipal hospitals Provincial or higher-level hospitals County
hospitals
Municipal hospitals Provincial or higher-level hospitals
ARR at PHC institutions 0.75**
(0.57, 0.99)
0.55***
(0.37, 0.82)
0.54***
(0.36, 0.82)
0.54***
(0.44, 0.66)
0.19***
(0.15, 0.24)
0.37***
(0.27, 0.50)
ARR at county hospitals 1.22***
(1.06, 1.41)
1.76***
(1.27, 2.45)
1.85***
(1.34, 2.56)
1.12
(0.91, 1.38)
1.68***
(1.39, 2.03)
2.18***
(1.74, 2.73)
Physicians density at PHC institutions 0.90***
(0.84, 0.97)
0.84***
(0.78, 0.91)
0.92*
(0.85, 1.00)
0.27***
(0.19, 0.36)
0.18***
(0.10, 0.30)
0.28***
(0.16, 0.48)
Physicians density at county hospitals 1.41***
(1.29, 1.53)
1.48***
(1.34, 1.64)
1.52***
(1.37, 1.69)
1.12***
(1.07, 1.17)
1.14***
(1.09, 1.20)
1.16***
(1.11, 1.22)
  1. *p < 0.05, **p < 0.01, ***p < 0.001