Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme

Wagstaff, Adam; Lindelöw, Magnus; Gao, Jun; Xu, Lei; Juncheng, Qian

doi:10.1016/j.jhealeco.2008.10.007

Cited by 595 publications

(539 citation statements)

References 24 publications

Supporting

Mentioning

492

Contrasting

Order By: Relevance

“…This result is consistent with the extensive use of fee-for-service reimbursement mechanisms for physicians which encourage the provision of discretionary drug and high-tech care. [3] Another finding was intensity (G cat ) of catastrophic health expenditure was still high in 2011 and its difference were small between pre-and post-reimbursement from 2004-2011. Moreover, rural households with higher income were better protected financially from catastrophic payments than household with the lowest incomes.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, much of the early literature found that the NRCMS increased the use of medical services and thereby actually increased total OOP payments for patients. [3,16,17] To summarize, there were considerable controversy concerning the threshold used to define catastrophic health care expenditures. While many studies that have assessed the impact of the NRCMS on catastrophic health care expenditures, most of those studies relied on early data or small-scale health surveys that were difficult to generalize.…”

Section: Literature Review On Catastrophic Health Care Expendituresmentioning

confidence: 99%

“…The NRCMS was operated at the county level and was largely focused, in most localities, on the cost of inpatient care. [3] There has been a rapid increase in this form of health insurance coverage in rural China since it was first introduced. Beginning with only 333 out of 2,862 rural counties in 2004, the NRCMS have expanded to cover all counties by the end of 2009 (China statistical yearbook, 2013).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Does the New Rural Cooperative Medical System with higher reimbursement rates reduce catastrophic health expenditures in rural China?

Zai-yu

Zhao

Coyte

2015

IJH

View full text Add to dashboard Cite

We used recently available data from the China Health and Nutrition Survey (CHNS) from 2004 to 2011 to re-examine the impact of the New Rural Cooperative Medical System (NRCMS) in the People's Republic of China on exposure to catastrophic health expenditures. We found that the NRCMS with universal coverage and higher reimbursement rates in 2011 did not reduce the incidence and intensity of out-of-pocket catastrophic payments. Moreover, there were important distributional implications with the poorest protected to the least extent. As such, we suggest policymakers should consider using the NRCMS to shelter rural residents, especially the poorest, from catastrophic medical expenses.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Literature Review On Catastrophic Health Care Expendituresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Does the New Rural Cooperative Medical System with higher reimbursement rates reduce catastrophic health expenditures in rural China?

Zai-yu

Zhao

Coyte

2015

IJH

View full text Add to dashboard Cite

show abstract

“…For example, Lei and Lin [24] find that the NCMS has no effect on health status, but they use selfreported health as the measure of health and combine adults and children together in their analysis. Wagstaff et al [33] find no evidence of the NCMS improving health status either. But Yip and Hsiao [39] use the Rural Mutual Health Care program implemented in one of China's western provinces as a quasi-natural experiment to investigate the effect of this health insurance program on participants' health status, measured by a 5-point categorical rating scale and the EQ-5D instruments.…”

Section: Introductionmentioning

confidence: 97%

“…Some research has demonstrated that the NCMS has contributed to the easement of the participants' out-ofpocket burden and has also increased their overall access to medical care [24,33]. The NCMS was designed in the following way.…”

Section: Introductionmentioning

confidence: 99%

The implication of health insurance for child development and maternal nutrition: evidence from China

Peng

Conley

2015

Eur J Health Econ

View full text Add to dashboard Cite

We use the implementation of the new rural cooperative medical scheme (NCMS) in China to investigate the effect of health insurance on maternal nutrition and child health. Given the uneven roll-out of the NCMS across rural counties, we are able to deploy its implementation as a natural experiment in order to obviate problems of adverse selection that typically plague research on the effects of health insurance. We find that, among children, the NCMS has the greatest positive effect on infants between birth and 5 years of age. Also, with respect to female nutritional status, our models show that the NCMS has the greatest effect on women of childbearing age (aged between 16 and 35), indicating that women who benefit from the NCMS benefits may, in turn, give birth to healthier babies. Thus, taken together, our findings indicate that the NCMS plays an important role in health dynamics in rural China.

show abstract

Health Care Delivery System: China

Jin

2014

The Wiley Blackwell Encyclopedia of Health, Illness, Behavior, and Society

View full text Add to dashboard Cite

China's health care delivery system mainly consists of village health stations, township health centers and country hospitals in rural areas, and hospitals and community health care centers in urban areas. Traditional Chinese medicine is an established component of the system. In the 1950s and 1960s, an extensive health care delivery system was set up to provide basic health care to the majority of China's vast population. After marketization reforms were initiated in 1978, the Chinese government withdrew from financing and managing health care provision. The pre‐reform system was greatly weakened, which exacerbated existing problems and created new challenges, such as lack of insurance coverage, soaring costs and spending, distorted provider incentives, patient–provider conflicts, lack of a functioning referral system, and inequality in access to available services. Since 2003 the Chinese government has led a campaign to address the problems. The most dramatic development has been the rapid expansion of public health care insurance programs, which now cover the majority of China's population, although the reimbursement rates are generally low. The government has recently professed its commitment to continue to improve health care provision; reform efforts to realign provider incentives and build a functioning referral system are unfolding. Rigorous examination is needed to assess their effects.

show abstract

Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme

Cited by 595 publications

References 24 publications

Does the New Rural Cooperative Medical System with higher reimbursement rates reduce catastrophic health expenditures in rural China?

Does the New Rural Cooperative Medical System with higher reimbursement rates reduce catastrophic health expenditures in rural China?

The implication of health insurance for child development and maternal nutrition: evidence from China

Health Care Delivery System: China

Contact Info

Product

Resources

About