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Abstractobjectives To evaluate the knowledge, attitude and behaviours of university students on the use of antibiotics.methods A knowledge-attitude-practice questionnaire was developed and distributed to undergraduate students of Xi'an Jiaotong University, comprising 18 schools/colleges in Shaanxi Province, western China. Chi-square test and logistic regression analysis were applied to identify risk factors associated with self-medication with antibiotics.

BackgroundAs an important outcome of the health system, equity in health service utilization has attracted an increasing amount of attention in the literature on health reform in China in recent years. The poor, who frequently require more services, are often the least able to pay, while the wealthy utilize disproportionately more services although they have less need. Whereas equity in health service utilization between richer and poorer populations has been studied in urban areas, the equity in health service utilization in rural areas has received little attention. With improving levels of economic development, the introduction of health insurance and increasing costs of health services, health service utilization patterns have changed dramatically in rural areas in recent years. However, previous studies have shown neither the extent of utilization inequity, nor which factors are associated with utilization inequity in rural China.MethodsThis paper uses previously unavailable country-wide data and focuses on income-related inequity of inpatient utilization and its determinants in Chinese rural areas. The data for this study come from the Chinese National Health Services Surveys (NHSS) conducted in 2003 and 2008. To measure the level of inequity in inpatient utilization over time, the concentration index, decomposition of the concentration index, and decomposition of change in the concentration index are employed.ResultsThis study finds that even with the same need for inpatient services, richer individuals utilize more inpatient services than poorer individuals. Income is the principal determinant of this pro-rich inpatient utilization inequity- wealthier individuals are able to pay for more services and therefore use more services regardless of need. However, rising income and increased health insurance coverage have reduced the inequity in inpatient utilization in spite of increasing inpatient prices.ConclusionsThere remains a strong pro-rich inequity of inpatient utilization in rural China. However, a narrowing income gap between the rich and poor and greater access to health insurance has effectively reduced income inequality, equalizing access to care. This suggests that the most effective way to reduce the inequity is to narrow the gap of income between the rich and poor while adopting social risk protection.

BackgroundHypertension is an important public health issue in China, but there are few studies on health-related quality of life (HRQoL) for patients with hypertension in China. This study aims to examine the HRQoL as measured by EQ-5D and investigate the factors that influence HRQoL for patients with hypertension in Shaanxi Province, China.MethodsData were collected from the Shaanxi’s fifth National Health Service Survey conducted in 2013. EQ-5D was employed to measure the HRQoL for patients with hypertension. The Chinese population-based preference trade-off time (TTO) model was used to convert the EQ-5D values. All descriptive analyses, including demographic characteristics, socio-economic status and clinical characteristics, were stratified by urban and rural residence. Tobit regression model was used to investigate the influencing factors of HRQoL.ResultsA statistically significant difference was observed between the EQ-5D utility scores of urban (0.891) and rural hypertension patients (0.870). The urban hypertension patients showed significantly higher utility scores than the rural patients in three of the five dimensions, namely usual activities, pain / discomfort and anxiety / depression. The influencing factors of HRQoL for hypertension patients in China included age, marital status, education level, employment status, physical activity and medical examination. For patients aged 55 years and above, EQ-5D utility score decreased significantly with increasing age. The EQ-5D score increased with higher education level. Married patients showed a higher EQ-5D score than divorced and widowed patients, and employed patients showed a higher score than unemployed and retired patients. Regular physical activity and medical examination had a positive effect on the HRQoL of hypertension patients.ConclusionsOur study indicated that urban hypertension patients might have higher HRQoL than rural patients in Shaanxi, China. To enhance HRQoL, it is necessary to strengthen the health education for hypertension patients to improve hypertension prevention and to adopt healthy habits such as regular physical activity. It is also important to strengthen the management and monitoring of hypertension in the elderly, and further implement the free medical examination program for the elderly under the public health programs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1536-x) contains supplementary material, which is available to authorized users.

BackgroundPolicy interventions have been taken to protect households from facing unpredictable economic changes that may cause catastrophe in China. This study aims to estimate the change of overall proportion of households incurring catastrophic health care expenditure (CHE) and its income-related inequality in the rural areas of Shaanxi Province from 2008 to 2013.MethodsThe data were drawn from the National Household Health Service Surveys of Shaanxi Province conducted in the years 2008 and 2013. In total, 3,217 households in 2008 and 13,085 households in 2013 were selected for analysis. A “Capacity to pay” approach was used to measure the incidence of CHE. The concentration index was employed to measure the extent of income-related inequality in CHE. A decomposition method, based on a logit model, was used to decompose the concentration index into its determining components.ResultsFrom 2008 to 2013, the overall proportion of households incurring CHE dropped from 17.19 % to 15.83 %, while conversely, the inequality in facing CHE strongly increased. The majority of observed inequalities in CHE were explained by household economic status and household size in 2013. In addition, the absence of commercial health insurance and having elderly members were also important contributors to inequality in CHE.ConclusionsEven though we used a conservative method to measure CHE, the overall proportion of households incurring CHE in Shaanxi Province is still considerably high in both years. Furthermore, there exists a strong pro-rich inequality of CHE in rural areas of Shaanxi Province. Our study suggests that narrowing the gap of household economic status, improving the anti-risk capability of small scale households, establishing prepayment mechanisms in health insurance, strengthening the depth of reimbursement and subsidising vulnerable households in Shaanxi Province are helpful for both reducing the probability of incurring CHE and the pro-rich inequality in CHE.