Individual vs household: How do different calculation patterns of catastrophic health expenditure matter? New evidence from China's critical illness insurance programme

Zhang, Ying; Ding, Hu; Guan, Yongmei; Vanneste, Jacques

doi:10.1002/hpm.2885

Cited by 5 publications

(4 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 2016, the Chinese government began to integrate two systems, Urban Residents Basic Medical Insurance (URBMI) and New Rural Cooperative Medical Scheme (NCMS), to establish a unified basic medical insurance system for urban and rural residents. By gradually improving system construction, medical expenses incurred by families due to critical illness can be further reduced ( 5 ). In October 2017, General Secretary Xi Jinping stated at the 19th National Congress of the Chinese Communist Party that it is necessary to strengthen the social security system and improve the unified basic critical illness insurance system for urban and rural residents.…”

Section: Introductionmentioning

confidence: 99%

Impact of Catastrophic Health Expenditures on Chinese Household Consumption

Wei

Huang

Zhou

2021

Front. Public Health

View full text Add to dashboard Cite

China has built a social medical insurance system that covers the entire population so as to reduce the impact of diseases on individuals and families. Although the decline in the incidence of catastrophic health expenditures (CHEs) in China is encouraging, this issue remains important. On the basis of considering selectivity bias and heterogeneity, we applied propensity score matching (PSM) to analyze the 2018 data from the China Family Panel Studies. We assigned CHE households and non-CHE households to the treatment group and the control group, respectively, and used non-random data to simulate a randomized trial to investigate the impact of CHE on household consumption in China. The results of this study indicate that, when the threshold is set at 40%, the consumption of households experiencing CHEs (CHE household) is significantly lower than that of households not experiencing CHEs (non-CHE households) and that CHEs have a significant negative impact on other household consumption and a significant impact on the household property and debt. This effect still exists when the threshold is set lower, with household essential consumption most affected. The occurrence of CHEs leads to a reduction in household consumption and a significantly worsening financial situation for the CHE households, impacting the basic quality of life of the families. Therefore, it is necessary to further reform the medical and health system to reduce the high medical expenses.

show abstract

Section: Introductionmentioning

confidence: 99%

Impact of Catastrophic Health Expenditures on Chinese Household Consumption

Wei

Huang

Zhou

2021

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…Certain studies compared CMI policy documents published in various regions, identifying shortcomings in the design and implementation of welfare packages and making recommendations for improvement [ 13 , 14 ]. By simulating various CMI compensation schemes, some studies compared the effects of CMI under various catastrophic health expenditure measurement methods and compensation schemes [ 15 , 16 , 17 , 18 , 19 ]. By examining the effectiveness of CMI implementation using datasets from health insurance information systems and survey data at some regional or national levels, some studies discovered that increased CMI coverage significantly effectively alleviated poverty caused by illness [ 20 ], and reduced vulnerability to poverty and broke the vicious cycle of poverty and disease through increased income [ 21 ].…”

Section: Literature Review and Research Hypothesismentioning

confidence: 99%

Healthcare Expenditures among the Elderly in China: The Role of Catastrophic Medical Insurance

Cao

You

et al. 2022

IJERPH

View full text Add to dashboard Cite

China has been piloting the catastrophic medical insurance (CMI) program since 2012 and rolled it out nationally in 2016 to reduce the incidence of catastrophic health expenditure among Chinese residents. Few studies have been conducted to determine its effect on healthcare expenditures, particularly among the elderly. The purpose of this study is to examine the effect of CMI on healthcare expenditures among China’s elderly population. The data for this study were derived from 4 waves of the Chinese Longitudinal Healthy Longevity Survey, which included 344 and 1199 individuals in the treatment and control groups, respectively. To examine the effect of CMI on healthcare expenditures among the elderly, we used difference-in-differences and fixed-effects models. Additionally, a heterogeneity analysis was used to examine the differences in the impact of CMI on different groups. Finally, we confirmed the robustness of the results using robustness and placebo tests. CMI increased total health and out-of-pocket expenditures significantly, as well as inpatient and corresponding out-of-pocket expenditures. The reassults of the heterogeneity analysis indicated that CMI had a greater impact on elderly residents of rural areas. Economic burden protection has been enhanced for low-income groups and patients with serious diseases over the last two years. Our research indicated that CMI can promote the use of inpatient medical services for the elderly to a certain extent. Targeted measures such as expanding the CMI compensation list, establishing a more precise compensation scheme, and specific diseases associated with high healthcare expenditures can be considered in the practice of CMI implementation.

show abstract

“…The two-layer CII models (41,42) are constructed to act as a bridge between the SRBMI and private health insurance (PHI). In these models, we assume that the CII covers all the enrollees of SRBMI and compensates inpatient medical expenses partially by the choice of the deductible, compensation ratio, and cap line.…”

Section: The Modelsmentioning

confidence: 99%

The Basic vs. Ability-to-Pay Approach: Evidence From China's Critical Illness Insurance on Whether Different Measurements of Catastrophic Health Expenditure Matter

Zhang

Guan

Ding

et al. 2021

Front. Public Health

Self Cite

View full text Add to dashboard Cite

Alleviating catastrophic health expenditure (CHE) is one of the vital objectives of health systems, as defined by the World Health Organization. However, no consensus has yet been reached on the measurement of CHE. With the aim of further relieving the adverse effects of CHE and alleviating the problem of illness-caused poverty, the Critical Illness Insurance (CII) program has been operational in China since 2012. In order to verify whether the different measurements of CHE matter under China's CII program, we compare the two-layer CII models built by using the basic approach and the ability-to-pay (ATP) approach at a range of thresholds. Exploiting the latest China family panel studies dataset, we demonstrate that the basic approach is more effective in relieving CHE for all insured households, while the ATP approach works better in reducing the severity of CHE in households facing it. These findings have meaningful implications for policymaking. The CII program should be promoted widely as a supplement to the current Social Basic Medical Insurance system. To improve the CII program's effectiveness, it should be based on the basic approach, and the threshold used to measure CHE should be determined by the goal pursued by the program.

show abstract

Individual vs household: How do different calculation patterns of catastrophic health expenditure matter? New evidence from China's critical illness insurance programme

Cited by 5 publications

References 13 publications

Impact of Catastrophic Health Expenditures on Chinese Household Consumption

Impact of Catastrophic Health Expenditures on Chinese Household Consumption

Healthcare Expenditures among the Elderly in China: The Role of Catastrophic Medical Insurance

The Basic vs. Ability-to-Pay Approach: Evidence From China's Critical Illness Insurance on Whether Different Measurements of Catastrophic Health Expenditure Matter

Contact Info

Product

Resources

About