Impact of the New Cooperative Medical Scheme on the trend of catastrophic health expenditure in Chinese rural households: results from nationally representative surveys from 2003 to 2013

Xie, Biao; Huo, Minghe; Wang, Zhi–Qiang; Chen, Yongjie; Fu, Rong; Liu, Meina; Meng, Qun

doi:10.1136/bmjopen-2017-019442

Cited by 22 publications

(20 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Since 2011, only three studies have focused on the trends in financial protection in China at the national level; they are all cross‐sectional in design . A study specifically focused on the roles of NCMS in protecting affected households from CHE in rural China in 2003–2013 found out that, even both the incidence and severity of CHE both decreased after NCMS reimbursements, the inequalities between different income groups persisted . Apart from the income‐related and region‐related disparity in financial protection were shown previous studies, the growing prevalence of chronic disease also contributed to high out‐of‐pocket payments (OOP) for health services and drugs.…”

Section: Introductionmentioning

confidence: 98%

“…Some studies have also examined the degree of CHE or health impoverishment at the sub‐national level or in rural areas in China . Since 2011, only three studies have focused on the trends in financial protection in China at the national level; they are all cross‐sectional in design . A study specifically focused on the roles of NCMS in protecting affected households from CHE in rural China in 2003–2013 found out that, even both the incidence and severity of CHE both decreased after NCMS reimbursements, the inequalities between different income groups persisted .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Trends and socio‐economic disparities in catastrophic health expenditure and health impoverishment in China: 2010 to 2016

Zhao

Oldenburg

Mahal

et al. 2019

Tropical Med Int Health

View full text Add to dashboard Cite

objectives To investigate trends and socio-economic disparities in the catastrophic health expenditure (CHE) and health impoverishment in China after major reform of the health system and to examine the impacts of the chronic disease on CHE and impoverishment.methods We obtained data from four rounds of the China Family Panel Studies 2010-2016, with a sample size of 14 960 households. We defined CHE as the point at which annual household health payments exceeded 40% of annual capacity to pay. Impoverishment is measured by the $1.90 per day poverty line. Multivariate logistic regression models were performed to identify impacts of the family member with chronic disease on CHE and impoverishment.results Between 2010 and 2016, the incidence of CHE in China decreased from 19.37% to 15.11% and from 7.39% to 5.14% for health impoverishment; however, the decrease in level of impoverishment was less in rural areas (from 6.16% down to 3.03%) than in urban areas (from 8.46% down to 7.81%). The gap between impoverishment rates across the income quartiles is growing. Multivariable analysis showed that households with two or more members suffering chronic diseases were significantly more likely to incur CHE (aOR: 2.46, 95% CI: 1.93-3.13) and impoverishment (aOR: 2.66, 95% CI: 1.87-3.78) than households with no members suffering chronic diseases, after adjusting for sociodemographic covariates.conclusions Important advances have been made in achieving greater financial protection for Chinese citizens. Nevertheless, greater attention to the poor households with chronic disease members is needed. Policymakers in China should focus on optimising integrated rural-urban health insurance by expanding the current benefit packages and strengthening poverty alleviation efforts.keywords catastrophic health expenditure, health impoverishment, socio-economic disparity, China Sustainable Development Goals (SDGs): SDG 1 (no poverty), SDG 3 (good health and well-being), SDG 8 (decent work and economic growth), SDG 10 (reduced inequalities), SDG 11 (sustainable cities and communities), SDG 17 (partnerships for the goals)

show abstract

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Trends and socio‐economic disparities in catastrophic health expenditure and health impoverishment in China: 2010 to 2016

Zhao

Oldenburg

Mahal

et al. 2019

Tropical Med Int Health

View full text Add to dashboard Cite

show abstract

“…Findings suggested that healthcare costs remain catastrophic for a large proportion of insured households in Ghana [15]. Two other studies by Xie et al [16] and Guo et al [17] evaluated the role of the Chinese new rural cooperative medical scheme (NRCMS) on protecting households from CHE using 40% of a household's capacity to pay as the threshold. Both reported that CHE incidence and intensity decreased after NCMS reimbursement.…”

Section: Introductionmentioning

confidence: 99%

Effect of Critical Illness Insurance on Household Catastrophic Health Expenditure: The Latest Evidence from the National Health Service Survey in China

Shi

Yang

et al. 2019

IJERPH

View full text Add to dashboard Cite

Background: China fully implemented the critical illness insurance (CII) program in 2016 to alleviate the economic burden of diseases and reduce catastrophic health expenditure (CHE). With an aging society, it is necessary to analyze the extent of CHE among Chinese households and explore the effect of CII and other associated factors on CHE. Methods: Data were derived from the Sixth National Health Service Survey (NHSS, 2018) in Jiangsu Province. The incidence and intensity of CHE were calculated with a sample of 3660 households in urban and rural areas in Jiangsu Province, China. Logistic regression and multiple linear regression models were used for estimating the effect of CII and related factors on CHE. Results: The proportion of households with no one insured by CII was 50.08% (1833). At each given threshold, from 20% to 60%, the incidence and intensity were higher in rural households than in urban ones. CII implementation reduced the incidence of CHE but increased the intensity of CHE. Meanwhile, the number of household members insured by CII did not affect CHE incidence but significantly decreased CHE intensity. Socioeconomic factors, such as marital status, education, employment, registered type of household head, household income and size, chronic disease status, and health service utilization, significantly affected household CHE. Conclusions: Policy effort should further focus on appropriate adjustments, such as dynamization of CII lists, medical cost control, increasing the CII coverage rate, and improving the reimbursement level to achieve the ultimate aim of using CII to protect Chinese households against financial risk caused by illness.

show abstract

“…Moreover, economical affluent groups are more likely to consume more medical services, which usually get more reimbursement [6][7] [8]. Since NCMS is Social Medical Insurance (SMI) and originally designed to be a financing approach for mobilizing funds and pooling risk, these mobilized funds should be allocated for the poor and near-poor rural residents rather than economically affluent groups [9].…”

Section: Resultsmentioning

confidence: 99%

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

Luo

Deng³

2019

Preprint

View full text Add to dashboard Cite

Background The New Cooperative Medical Scheme (NCMS) is a social health insurance available to rural Chinese residents. Over time, several concerns to this system have been raised, including disparities among healthcare utilization and expenditures. Most studies only discuss disparities in general in NCMS, with few studies concentrating on comparing disparities between urban and rural regions. Moreover, this issue has an increasing importance due to the rapid population growth of rural migrants. Therefore, we conducted our study to explore urban and rural disparities among NCMS beneficiaries.Methods Our study is based on Chinese Health and Retirement Longitudinal Study (CHARLS) for 2015. Our targeted sample is individuals with rural hukou and only covered by NCMS. We define and use influential factors in our logistic regressions and descriptive tables to compare urban and rural disparities among these NCMS beneficiaries. Results In terms of inpatient care, urban beneficiaries have a lower probability (OR=1.013, P=0.892) and frequency (1.39 vs. 1.47, P=0.131) of having an inpatient visit than rural beneficiaries. However, urban beneficiaries have higher out-of-pocket (OOP) expenditures among inpatient visit (￥6788.98 vs. ￥6163.92, P=0.470) and medicine (￥3907.30 vs. ￥2649.67, P<0.01). In addition, urban beneficiaries were found to have higher reimbursement of inpatient visit (￥4457.66 vs. ￥4127.83, P<0.001) and medicine (￥2466.93 vs. ￥1774.55, P<0.05). In terms of outpatient care, urban beneficiaries have less possibility (OR=1.074, P=0.384) and frequency (2.15 vs. 2.26, P=0.225) of an outpatient visit than rural beneficiaries. Moreover, compared to rural beneficiaries, urban beneficiaries have less out-of-pocket (OOP) expenditures of outpatient visit (￥709.80 vs. ￥ 710.98, P=0.608) and drugs (￥448.68 vs. ￥ 522.95, P=0.645), and less reimbursement of outpatient visit (￥296.03 vs. ￥ 344.51, P=0.808) and drugs (￥99.25 vs. ￥ 114.60, P<0.05).Conclusion In terms of healthcare utilization, rural beneficiaries have both higher probability and frequency of inpatient and outpatient visits. In terms of healthcare expenditures, urban beneficiaries get more inpatient reimbursement with higher inpatient expenditures, while rural beneficiaries get more outpatient reimbursement with higher outpatient expenditures. Both situations have not solid answer yet, and therefore require further research.

show abstract

Impact of the New Cooperative Medical Scheme on the trend of catastrophic health expenditure in Chinese rural households: results from nationally representative surveys from 2003 to 2013

Cited by 22 publications

References 20 publications

Trends and socio‐economic disparities in catastrophic health expenditure and health impoverishment in China: 2010 to 2016

Trends and socio‐economic disparities in catastrophic health expenditure and health impoverishment in China: 2010 to 2016

Effect of Critical Illness Insurance on Household Catastrophic Health Expenditure: The Latest Evidence from the National Health Service Survey in China

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

Contact Info

Product

Resources

About