<p>The Effect of New Rural Cooperative Medical Scheme on the Socioeconomic Inequality in Inpatient Service Utilization Among the Elderly in China</p>

Abstract

Background and Aim: Health equity is an important goal of health policy, and the equalization of access to health care plays a vital role in guaranteeing it. The aim of this study was to use the cross-sectional data to explore the effect of New Rural Cooperative Medical Scheme (NRCMS) on the socioeconomic inequality in inpatient service utilization among the elderly in china. Methods: The data of this study were obtained from the 2018 wave of China Family Panel Studies (CFPS), involving 3645 older adults aged 60 and above. Furthermore, concentration index and concentration curve were employed to measure the socioeconomic inequality in inpatient service utilization. Moreover, this study used multiple linear regression model to explore the effect of NRCMS on inpatient service utilization. In addition, this study adopted the decomposition of concentration index to investigate the effect of NRCMS on the socioeconomic inequality of inpatient service utilization. Results: The concentration index of inpatient expense for the older people was 0.0538, and its concentration curve lays below the diagonal. The regression result indicates that NRCMS was significantly associated with higher inpatient expense among the elderly (coefficient = 0.8749, p < 0.01). The decomposition result reveals that the contribution rate of NRCMS to concentration index was −2.29%, which indicates that its contribution on reducing pro-rich inequality in inpatient service utilization was limited. Conclusion: This study demonstrates that there was a pro-rich inequality in inpatient service utilization among the elderly. Furthermore, NRCMS was significantly associated with higher inpatient expense. Moreover, NRCMS only played a limited role in reducing prorich inequality in inpatient service utilization.

Trends in equity of inpatient health service utilization for the middle-aged and elderly in China: based on longitudinal data from 2011 to 2018

“…In the present study, we did observe that the level of IHSU among the middle-aged and elderly in China increased from 2011 to 2018. This phenomenon is consistent with our hypothesis and is also consistent with the other studies among the elderly in China [ 16 , 29 ]. The medical security system is known to have a positive impact on IHSU; accordingly, the increasing rate of IHSU may be related to the massive increase in demand for medical care following the introduction of medical security systems [ 30 , 31 ].…”

“…This phenomenon is consistent with our hypothesis and is also consistent with the other studies among the Fig. 2 The rate of annual inpatient health service utilization from 2011 to 2018 elderly in China [16,29]. The medical security system is known to have a positive impact on IHSU; accordingly, the increasing rate of IHSU may be related to the massive increase in demand for medical care following the introduction of medical security systems [30,31].…”

“…Some scholars have suggested that inequality should be reduced by reducing the income gap between the rich and the poor through social risk protection after a study on the equity of IHSU in rural areas of China [3]. Some scholars have also studied the equity of IHSU among the elderly and found that there is an inequality that tends to be higher-economic groups, while the New Rural Cooperative Medical Scheme is less effective in reducing this inequality [16]. In addition, the National Health Service survey of China has showed a gradually enhancing trend in IHSU rate (from 6.8% in 2008 to 9.0% in 2013) for the all-age population [17,18].…”

Analysis on the willingness and influencing factors of choosing primary healthcare institutions among patients with chronic conditions in China: a cross-sectional study

“…However, previous studies concluded that residents who participated in NCMS were more willing to choose PHC institutions. 28 The above conclusions could indeed be drawn from the unifactorial analysis, but when individual characteristics, such as residence, age and education level, are considered, the influence of NCMS is no longer significant. One possible reason is that the individual characteristics of the insured group, rather than the type of insurance, affects medical preference.…”

“…Moreover, CFPS sampled approximately 57 000 individuals from 15 000 households in 25 provinces of China by using a multistage probability-proportional-to-size sampling technique. 28 This study used data from 2016 and 2018, which are the latest two waves. A total of 36 892 adults were surveyed in 2016 and 37 354 were surveyed in 2018.…”