title: Equity of the essential public health service in rural china: evidence from a nationwide survey of hypertensive patients.
abstract: OBJECTIVE
  To explore healthcare disparities in rural China two years after the implementation of the Essential Public Health Service (EPHS) reform in 2009.
  
  
  METHODS
  A cross-sectional study was conducted by surveying 930 hypertension patients (HPs) from different regions in rural China in 2011. The percentages of patients using recommended four or more follow-up visits in a year were calculated by patient socio-demographic characteristics and statistically examined using chi-square and logistic regression to uncover disparities and correlated factors in EPHS use.
  
  
  RESULTS
  The rates were not significantly different by age, gender, education, insurance status or income, but significantly different by region and hypertension history (p<0.01). Higher rates were also observed on patients who sought actively follow-up service at clinics, making appointment for the next follow-up with doctors, awareness of the need of follow-up, more satisfied with the follow-up services, and better medication adherence (p<0.01).
  
  
  CONCLUSIONS
  There were no disparities observed among HPs in the use of follow-up services, suggesting that the reform has to some extent achieved its goal in ensuring equal access to EPHS. In this regard, regional implementation of the national policies and improvement of EPHS management at local level should be further improved.
authors.affiliation: Donghua Zhou, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Donghua
authors.initials: D
authors.lastname: Zhou
authors.affiliation: Zhanchun Feng, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Zhanchun
authors.initials: Z
authors.lastname: Feng
authors.affiliation: Shasha He, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Shasha
authors.initials: S
authors.lastname: He
authors.affiliation: Xi Sun, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Xi
authors.initials: X
authors.lastname: Sun
authors.affiliation: Caihui Ma, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Caihui
authors.initials: C
authors.lastname: Ma
authors.affiliation: Benyan Lv, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Benyan
authors.initials: B
authors.lastname: Lv
authors.affiliation: Xiong Zou, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, PR China.
authors.forename: Xiong
authors.initials: X
authors.lastname: Zou
keywords: Equity; Essential public health services; Hypertensive patients; Rural China