Demand for social health insurance: Evidence from the Chinese New Rural Cooperative Medical Scheme

Abstract

This paper assesses the determinants of enro lment in the New Rural Cooperative Medical Scheme (NRCM S), a heavily subsidized voluntary health insurance scheme in rural China. The analys es focus on the relationship between insurance purchase and health facility choice based on data drawn fro m the China Health and Nutrit ion Survey (CHNS). The results show that households fro m villages that reported use of village clin ics are more likely to be insured compared with households from villages that reported use of county hospitals. The results indicate that the perception of quality of care is an important factor affecting people's enrolment decisions. The NRCM S is expected to help patients obtain better quality health services fro m higher-t ier of the healthcare system that are unaffordable otherwise. However, given the prevailing fee-for-service pay ment mechanism for health care, the insurance may also drive up the healthcare cost and direct patients to use more expensive and unnecessary hospital care.

Analysis of the Impact of China’s Hierarchical Medical System and Online Appointment Diagnosis System on the Sustainable Development of Public Health: A Case Study of Shanghai

“…It is necessary for the government to take the lead in efforts to expand the grassroots level, particularly the medical talents in rural areas. Governments should encourage medical graduates to work at the grass-roots level in rural areas, raise the income of medical personnel at the grass-roots level through practical measures, and encourage doctors to practice more so as to effectively improve the diagnosis and treatment capability of low-level medical institutions [64][65][66].…”

“…(2) Accelerate the information and network construction of the whole medical system and further construct the intelligent referral matching and tele-medicine treatment system of different levels in medical institutions by using cloud platform that on the basis of the existing online appointment system. Through real-time sharing and intelligent matching of patients data between different levels of medical institutions, the hierarchical referral and online appointment system are optimized to further enhance the ultimate time utility of patients [66][67][68][69].…”

Urban and Rural Disparities in Healthcare Utilization and Expenditures Among Rural Hukou Beneficiaries of New Cooperative Medical Scheme in China

“…In terms of outpatient care, we find an inverse situation that urban beneficiaries spend less and get less reimbursement, so there is a pro-poor inequity. In our opinion, this phenomenon can be partly explained price elasticity [7]. Compared to inpatient care, the price of outpatient care is more reasonable to most beneficiaries, so they will seek outpatient care instead of inpatient care as far as possible.…”

The Effect of China’s Health Insurance on the Labor Supply of Middle-aged and Elderly Farmers

“…This section considers a two-stage model based on Bai and Wu [ 35 ] and Wang and Peng [ 36 ] utility models to explain the impact of health insurance on labor supply. Equation (2) expresses the constraints of the first period.…”