Sense of public medical fairness and influencing factors based on data of the Chinese Social Survey (CSS) (2017–2019)

Abstract

Background: The objective of this study was to have a better view of the sense and influencing factors of public medical fairness from the public perspective, which would provide objective evidence for decision-makers to facilitate the improvement of a multi-tiered medical security system. Methods: This study was based on data from the Chinese Social Survey (CSS) in 2015, 2017, and 2019; the CSS is a cross-sectional survey in China. Indicators of social-demographic characteristics were included as independent variables, while evaluation of public medical care, which we named as “sense of public medical fairness”, was selected as the dependent variable. Data were analyzed using descriptive statistics, Chi-square test, analysis of variance (ANOVA), and multi-class logistic regression. Results: The study revealed that, from 2015 to 2019, the sense of public medical fairness significantly increased (F=64.473, P<0.0001) and there was a significant move toward the direction of “very fair” of the radar map (P<0.0001). In 2015, there was positive correlation between internet use and sense of public medical fariness, however internet usage became negative impact on the evaluation of sense of public medical fairness. Security such as pension insurance or pension, medical insurance or public medical care, maternity insurance, unemployment insurance, injury insurance and subsistence allowance are playing increasing roles in the evaluation of sense of public medical fairness and most of them had protective effect on sense of public medical fairness. Conclusion: Policy makers should promote the transformation of medical and health services in the digital era and explore and guide the positive impact of digital society on the development of medical and health services to enhance citizens' sense of fairness.