Does the medical insurance system really achieved the effect of poverty alleviation for the middle-aged and elderly people in China? Characteristics of vulnerable groups and failure links

Ma, Meiyan; Li, Ye; Wang, Nianshi; Wu, Qunhong; Shan, Linghan; Jiao, Mingli; Fu, Xiangsheng; Li, Heng; Sun, Tao; Yi, Bin; Tian, Wanxin; Xia, Qi; Shi, Baoguo; Hao, Yanhua; Yin, Hui; Ning, Ning; Gao, Lijun; Liang, Libo; Wang, Jiahui

doi:10.1186/s12889-020-08554-3

Cited by 31 publications

(24 citation statements)

References 40 publications

(38 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The older you are, the greater the risk for getting sick, especially degenerative diseases (Laksono, Nantabah and Wulandari, 2018;Wulandari and Laksono, 2019), including accidents (Kanters et al, 2020). Similar findings are also informed in several previous studies in various countries which concluded that the older a person is, the higher the risk of experiencing illness (Ma et al, 2020;Jaramillo and Willging, 2021;Wang et al, 2021).…”

Section: Resultssupporting

confidence: 73%

Health Insurance Ownership among Mollucans in Indonesia

Laksono¹,

Sillehu²,

Khoiri³

et al. 2020

Preprint

View full text Add to dashboard Cite

Health insurance is an effort to transfer risks to increase public access to the use of health services. The study was aimed at analyzing factors related to health insurance ownership among Mollucans in Indonesia. The sample size was 788 respondents. The variables analyzed included health insurance ownership, age group, gender, education level, employment status. The final stage was employed multinomial logistic regression. The results show Mollucans in the ≤19 age group were 0.182 times more likely than Mollucans in the ≥ 50 age group to have government-run type health insurance. Mollucans in the 20-29 age group were 0.219 times more likely than Mollucans in the ≥ 50 age group to have government-run health insurance. On the other hand, Mollucans with primary education was 0.196 times more likely than Mollucans with higher education to have a government-run type of health insurance. Mollucans with secondary education was 0.415 times more likely than Mollucans with higher education to have government-run health insurance. Meanwhile, unemployed Mollucans have a probability of 0.358 times compared to employed Mollucans to have the government-run type of health insurance. Finally, unemployed Mollucans are 0.056 times more likely than employed Mollucans to have private-run health insurance. It was concluded that 3 proven variables associated with health insurance ownership among Moluccans in Indonesia, namely age group, education level, and employment status.

show abstract

Section: Resultssupporting

confidence: 73%

Health Insurance Ownership among Mollucans in Indonesia

Laksono¹,

Sillehu²,

Khoiri³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…However, this finding is contrary to previous studies which have suggested that households headed by a female, an unemployed person or a person having little education were more likely to be beneficial from NRCMS [ 36 , 37 ]. In a recent study, Ma [ 38 ] thought that the age of the head of household influenced the poverty level due to healthcare expenditure. As the age of the head of household increases, the risk of poverty increases by 1.83 percentage point.…”

Section: Discussionmentioning

confidence: 99%

“…For the area difference, Wang and Liu [ 41 ] also found that the impact of NRCMS on alleviating poverty is greater in central and western China where society and economy develop more slowly than eastern China. Ma [ 38 ] found that the economic development-focused approach to regional poverty alleviation has not reached the maximum point of convergence with China’s current demand for health. There are two factors that can explain: on the one hand, people living in eastern China focus more on healthcare so that they purchase more health goods and have more financial burden.…”

Section: Discussionmentioning

confidence: 99%

The impact of health insurance on poverty among rural older adults: an evidence from nine counties of western China

Zhai

Yuan

Dong

2021

Int J Equity Health

View full text Add to dashboard Cite

Background Older adults are more prone to various diseases. Health insurance becomes effective mechanism to relieve financial burden when the insured is sick. In China, most older adults live in the countryside, and New Rural Cooperative Medical Scheme is a kind of health insurance system in rural areas. The relationship between New Rural Cooperative Medical Scheme and financial burden due to health expenditure of older adults in China was investigated. This paper aims at the impact of New Rural Cooperative Medical Scheme on the poverty among rural older adults. Methods This study employs Probit model and Tobit model to assess the impact of New Rural Cooperative Medical Scheme on alleviating poverty among rural older adults based on a survey in nine representative counties in western China. Results The findings show that diseases have significantly negative impact on rural elderly poverty. New Rural Cooperative Medical Scheme has impact on alleviating of the health-payment poverty due to catastrophic health expenditure, but the impact is limited. The impact of health insurance on poverty alleviation is greater for men, older adults aged between 60 to 69 and households in in economically poorer area than their counterparts. Conclusions This study show the relationship between New Rural Cooperative Medical Scheme and catastrophic health expenditure of older adults in China. The results draw policy attention to introduce different reimbursement expense ratios for different groups to alleviate them from poverty based on more comprehensive insurance packages.

show abstract

“…15 Although China has launched since 2012 major disease medical insurance schemes for patients to deal with the economic burden of such diseases, the compensation level and bene t coverage for major diseases still need to increase. 16 Some tumor diseases, such as benign brain tumor, were not even covered by the major disease medical health insurance schemes, contributing to the high economic burden of residents. Moreover, patients suffering from mental illness shared more OOP expenses due to insu cient reimbursement.…”

Section: Poverty and Medical Impoverishment Under Different Medical Imentioning

confidence: 99%

What fragile factors hinder the pace of China’s alleviation efforts of poverty-stricken population?

Shan

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Objective: China has made remarkable achievements in poverty alleviation. However, with the change in economic development and age structure, the population stricken by poverty due to medical expenses and disability accounted for 42.3% and 14.4% of the total poverty-stricken population, respectively. The efforts to reduce the catastrophic health expenditure among Chinese residents are not optimistic. Poverty alleviation efforts might only focus on the people who are currently poor but ignores the increase in poverty that may occur. Accordingly, it is crucial to accurately pinpoint the characteristics of people who are about to become poor due to illness. Therefore, we prospectively analyzed the incidence of impoverishment by medical expense at the provincial, family, and different medical insurance scheme levels to identify the precise groups that are vulnerable to medical-related poverty.Method: This study obtained the data from the Chinese government’s Fifth National Health Service Survey for 2013. This survey is conducted every five years and has the most nationally representative sample obtained through a multi-stage, stratified, and random sampling method. To clean the data, we excluded incomplete records and those with logic errors, leaving 93,570 households (273,626 people) for the final sample. The method recommended by World Health Organization (WHO) was adopted to calculate impoverishment by medical expense, and logistic regression was adopted to evaluate its determinants.Results: The poverty rates in western region had much higher poverty rates than the other two regions, and the eastern region had the lowest. The rate of medical impoverishment (MI) was higher in the western region (7.2%) than that in the central (6.5%) and eastern (5.1%) regions. Compared with people enrolled in other medical insurance schemes, those enrolled in the Medical Insurance for Urban Employees Scheme (UE-BMI) and a mixture of schemes had better capacity to deal with the burden brought by diseases. The New Cooperative Medical Scheme (NCMS)was associated with the highest rate (9.1%) of MI cases. A comparison of the MI groups revealed that the top three diseases associated with MI were malignant tumor, congenital heart disease, and mental disease. Households with members suffering from NCDs, and with members who were inpatients were all more likely to suffer from MI. NCMS-enrolled households had greater exposure to the risk of MI, at 1.84 times that of UE-BM-enrolled households. Poorer households were 15.8 times more likely to suffer from MI than richer households.Conclusion: The joint roles of economic development, health service utilization, and welfare policies result in medical impoverishment for different regions. Poverty and health service utilization are indicative of households with high incidence of medical impoverishment. Chronic diseases lead to medical impoverishment. The inequity existing in different medical insurance schemes leads to different degrees of risk of MI. A combined strategy to precise target multiple vulnerabilities of poor population should be more effective.

show abstract

Does the medical insurance system really achieved the effect of poverty alleviation for the middle-aged and elderly people in China? Characteristics of vulnerable groups and failure links

Cited by 31 publications

References 40 publications

Health Insurance Ownership among Mollucans in Indonesia

Health Insurance Ownership among Mollucans in Indonesia

The impact of health insurance on poverty among rural older adults: an evidence from nine counties of western China

What fragile factors hinder the pace of China’s alleviation efforts of poverty-stricken population?

Contact Info

Product

Resources

About