Is Travel Time Associated with Health Service Utilization in Northwest China? Evidence from Shaanxi Province

Figures & data

Table 1 Sample Characteristics of Survey Respondents Who Reported Illness in the 2 Weeks Before the Survey (%)

	All	Rural	Urban	P^a
	(n=9648)	(n=7474)	(n=2174)
Gender
Male	44.1	42.3	50.1	0.000
Female	55.9	57.7	49.9
Age groups
Young (15–44)	17.5	18.6	13.7	0.000
Middle (45–59)	36	38.3	28.1
Old (≥ 60)	46.5	43.1	58.2
Marriage
Unmarried	3.6	3.9	2.6	0.000
Married	81.7	80.9	84.8
Divorced or widowed	14.7	15.3	12.6
Education
Illiteracy	23.9	28.5	8.1	0.000
Elementary	29.1	33	15.9
Middle school	30.6	30.5	31.0
High school and above	16.4	8.0	45.0
Employment
Employed	62.1	72.5	26.3	0.000
Retired	14.0	2.1	54.8
Unemployed	23.9	25.4	19
Household size
1–2 residents	46.4	45.0	51.2	0.000
3–4 residents	37.8	37.5	38.7
More than 5 residents	15.8	17.4	10.1
Annual household income (Yuan)
Low	28.0	33.2	10.3	0.000
Middle	38.3	40.1	32.0
High	33.7	26.7	57.6
Insurance
No	1.0	0.4	3.1	0.000
Yes	99.0	99.6	96.9
Chronic disease
No	24.3	26.6	16.1	0.000
Yes	75.7	73.4	83.9
Self-report health
<60	14.5	14.5	14.4	0.637
60–79	38.8	38.5	39.6
80–100	46.8	47.0	46.0
Travel time to nearest medical service
Less than 5 min	15.1	16.2	11.5	0.000
5–14 min	54.0	50.5	65.8
15–29 min	18.5	18.2	19.6
More than 30 min	12.4	15.1	3.0
Health services utilization
No	57.4	53.0	72.6	0.000
Yes	42.6	47.0	27.4
Number of health services utilization^b
1	71.7	72.1	69.5	0.068
2	18.1	18.2	17.6
3 and above	10.2	9.7	12.9

Notes: ^aP for difference between rural and urban, x² test was used, statistical significance was P < 0.05; ^bTotal sample size of health services utilization was 3914, 3364 for rural, and 550 for urban.

Figure 1 Health services utilization rate in different travel time.

Table 2 Binary Logistic Regression for the Association Between Travel Time and Health Service Utilization

Travel Time to Nearest Medical Service^a	ALL	Rural	Urban
	OR^b (95% CI^c)	OR (95% CI)	OR (95% CI)
Less than 5 min	ref.	ref.	ref.
5–14 min	0.96(0.84,1.08)	0.98(0.86,1.13)	1.22(0.88,1.69)
15–29 min	0.94(0.81,1.09)	0.94(0.80,1.11)	1.32(0.90,1.92)
More than 30 min	1.15(0.98,1.36)	1.12(0.94,1.33)	2.12(1.16,3.87) *

Notes: ^aThe model was adjusted for gender, age, household income, education levels, employment status, household size, insurance states, chronic disease states, and self-report health; *Statistically significant (P < 0.05).

Abbreviations: ^bOR, odds ratio; ^cCI, confidence interval.

Table 3 Negative Binomial Regression of Association Between Travel Time and Frequency of Health Services Utilization

Travel Time^a		IRR^b (95% CI^c)	P value
All
	5–14 min	0.97(0.90, 1.05)	0.46
	15–29 min	0.97(0.88, 1.07)	0.52
	More than 30 min	1.05(0.94, 1.16)	0.40
Rural
	5–14 min	0.98(0.91, 1.07)	0.70
	15–29 min	0.98(0.89, 1.08)	0.67
	More than 30 min	1.02(0.92, 1.14)	0.66
Urban
	5–14 min	1.12(0.86, 1.47)	0.41
	15–29 min	1.15(0.84, 1.58)	0.38
	More than 30 min	1.77(1.09, 2.83) *	0.02

Notes: ^aThe model was adjusted for gender, age, household income, education levels, employment status, household size, insurance states, chronic disease states, and self-report health; *Statistically significant (P < 0.05).

Abbreviations: ^bIRR, incident rate ratios; ^cCI, confidence interval.