IDEAS home Printed from https://ideas.repec.org/a/bla/ijhplm/v35y2020i5p1111-1126.html
   My bibliography  Save this article

Government health expenditure, out‐of‐pocket payment and social inequality: A cross‐national analysis of China and OECD countries

Author

Listed:
  • Dunfu Zhang
  • K. M. Atikur Rahman

Abstract

This study aims to assess the association between Chinese out‐of‐pocket payments and government health spending, investigating their variation ratio in the context of OECD countries. Aggregated time‐series data of 37 countries (from China and official OECD members) were collected from the World Bank Open Data source and analyzed using the multiple linear regression models. Benchmarking approach was applied to evaluate the causes of healthcare expenditure rise per capita. The results showed that China's government health expenditure was positively associated with out‐of‐pocket payment rise, with a higher variation score of 42.70%. The association was statistically significant at 5%. Likewise, the association between government expenditure and out‐of‐pocket payment in the OECD countries was positively significant at 1%, and their variation score was 2.41%. Health financing in OECD countries showed higher stability and equity than that in China. Policy implications for China is to reduce the distributional disparity of government health funds by tax adjustments in health services, universal health coverage, the removal of social health insurance disparities, and a single health payment method.

Suggested Citation

  • Dunfu Zhang & K. M. Atikur Rahman, 2020. "Government health expenditure, out‐of‐pocket payment and social inequality: A cross‐national analysis of China and OECD countries," International Journal of Health Planning and Management, Wiley Blackwell, vol. 35(5), pages 1111-1126, September.
  • Handle: RePEc:bla:ijhplm:v:35:y:2020:i:5:p:1111-1126
    DOI: 10.1002/hpm.3017
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hpm.3017
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hpm.3017?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Kaushalendra Kumar & Ashish Singh & Santosh Kumar & Faujdar Ram & Abhishek Singh & Usha Ram & Joel Negin & Paul R Kowal, 2015. "Socio-Economic Differentials in Impoverishment Effects of Out-of-Pocket Health Expenditure in China and India: Evidence from WHO SAGE," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-19, August.
    2. Audibert, Martine & Mathonnat, Jacky & Pelissier, Aurore & Huang, Xiao Xian & Ma, Anning, 2013. "Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data," China Economic Review, Elsevier, vol. 27(C), pages 326-338.
    3. Dong, Keyong, 2009. "Medical insurance system evolution in China," China Economic Review, Elsevier, vol. 20(4), pages 591-597, December.
    4. Moheddine Younsi & Mohamed Chakroun & Amine Nafla, 2016. "Robust analysis of the determinants of healthcare expenditure growth: evidence from panel data for low-, middle- and high-income countries," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(4), pages 580-601, October.
    5. Kejia Chu & Ning Zhang & Zhongfei Chen, 2015. "The Efficiency and Its Determinants for China’s Medical Care System: Some Policy Implications for Northeast Asia," Sustainability, MDPI, vol. 7(10), pages 1-20, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Chen, Mingsheng & Xu, Lizheng & Si, Lei & Wang, Zhonghua & Jan, Stephen, 2023. "Examining the level and distribution of catastrophic health expenditure from 2013 to 2018: A province-level study in China," Economic Modelling, Elsevier, vol. 121(C).
    2. Si, Yafei & Bateman, Hazel & Chen, Shu & Hanewald, Katja & Li, Bingqin & Su, Min & Zhou, Zhongliang, 2023. "Quantifying the financial impact of overuse in primary care in China: A standardised patient study," Social Science & Medicine, Elsevier, vol. 320(C).
    3. Si Shi & Yawen Jiang, 2022. "Does supplemental private health insurance incentivize household risky financial asset investment? Evidence from the China Household Financial Survey," International Journal of Health Economics and Management, Springer, vol. 22(4), pages 369-421, December.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Laurène PETITFOUR & Xiezhe HUANGFU & Martine AUDIBERT & Jacky MATHONNAT, 2017. "Efficiency of township hospitals in China in the context of the drug policy reform: Progress should not get bogged in midstream - A case study from a survey in Weifang prefecture," Working Papers P185, FERDI.
    2. Tong Liu & Yufei Gao & Hui Li & Liping Zhang & Jiangjie Sun, 2022. "Analysis of the Operational Efficiency of Basic Medical Insurance for Urban and Rural Residents: Based on a Three-Stage DEA Model," IJERPH, MDPI, vol. 19(21), pages 1-20, October.
    3. Kejia Chu & Ning Zhang & Zhongfei Chen, 2015. "The Efficiency and Its Determinants for China’s Medical Care System: Some Policy Implications for Northeast Asia," Sustainability, MDPI, vol. 7(10), pages 1-20, October.
    4. Laurène PETITFOUR & Xiezhe HUANGFU & Martine AUDIBERT & Jacky MATHONNAT, 2017. "Efficiency of township hospitals in China in the context of the drug policy reform: Progress should not get bogged in midstream - A case study from a survey in Weifang prefecture," Working Papers P185, FERDI.
    5. Bo Li & Muhammad Mohiuddin & Qian Liu, 2019. "Determinants and Differences of Township Hospital Efficiency among Chinese Provinces," IJERPH, MDPI, vol. 16(9), pages 1-16, May.
    6. Kumar, Kaushalendra & Shukla, Ankita & Singh, Abhishek & Ram, Faujdar & Kowal, Paul, 2016. "Association between wealth and health among older adults in rural China and India," The Journal of the Economics of Ageing, Elsevier, vol. 7(C), pages 43-52.
    7. Cheung, Diana & Padieu, Ysaline, 2015. "Heterogeneity of the Effects of Health Insurance on Household Savings: Evidence from Rural China," World Development, Elsevier, vol. 66(C), pages 84-103.
    8. Kuangnan Fang & BenChang Shia & Shuangge Ma, 2012. "Health Insurance Coverage and Impact: A Survey in Three Cities in China," PLOS ONE, Public Library of Science, vol. 7(6), pages 1-8, June.
    9. Rahman, Md Mizanur & Jung, Jenny & Islam, Md Rashedul & Rahman, Md Mahfuzur & Nakamura, Ryota & Akter, Shamima & Sato, Motohiro, 2022. "Global, regional, and national progress in financial risk protection towards universal health coverage, 2000–2030," Social Science & Medicine, Elsevier, vol. 312(C).
    10. Yongrok Choi & Malin Song & Seunghwan Myeong, 2016. "Introduction to the Special Issue on the Sustainable Asia Conference 2015," Sustainability, MDPI, vol. 8(3), pages 1-9, March.
    11. Anshul Kastor & Sanjay K Mohanty, 2018. "Disease-specific out-of-pocket and catastrophic health expenditure on hospitalization in India: Do Indian households face distress health financing?," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-18, May.
    12. Liu, Hong & Fang, Hai & Zhao, Zhong, 2013. "Urban–rural disparities of child health and nutritional status in China from 1989 to 2006," Economics & Human Biology, Elsevier, vol. 11(3), pages 294-309.
    13. Jiaqi Chen & Song Xu & Jing Gao, 2020. "The Mixed Effect of China’s New Health Care Reform on Health Insurance Coverage and the Efficiency of Health Service Utilisation: A Longitudinal Approach," IJERPH, MDPI, vol. 17(5), pages 1-13, March.
    14. Jay Dev Dubey, 2021. "Measuring Income Elasticity of Healthcare-Seeking Behavior in India: A Conditional Quantile Regression Approach," Journal of Quantitative Economics, Springer;The Indian Econometric Society (TIES), vol. 19(4), pages 767-793, December.
    15. Jing You, 2016. "Lending to Parents and Insuring Children: Is There a Role for Microcredit in Complementing Health Insurance in Rural China?," Health Economics, John Wiley & Sons, Ltd., vol. 25(5), pages 543-558, May.
    16. Byaro, Mwoya & Kinyondo, Abel & Michello, Charles & Musonda, Patrick, 2018. "Determinants of Public Health Expenditure Growth in Tanzania: An Application of Bayesian Model," African Journal of Economic Review, African Journal of Economic Review, vol. 6(1), January.
    17. Haiyan Jia & Xiaoyu Sai & Yangyue Su & Ying Huang, 2022. "Measurement and Decomposition of the Health Poverty of Rural Residents in China," IJERPH, MDPI, vol. 19(19), pages 1-20, October.
    18. Zhan Wang & Jingjing Li & Chunxue Wang & Xiaomei Yao & Xingquan Zhao & Yilong Wang & Hao Li & Gaifen Liu & Anxin Wang & Yongjun Wang, 2013. "Gender Differences in 1-Year Clinical Characteristics and Outcomes after Stroke: Results from the China National Stroke Registry," PLOS ONE, Public Library of Science, vol. 8(2), pages 1-9, February.
    19. Berger, Michael & Sommersguter-Reichmann, Margit & Czypionka, Thomas, 2020. "Determinants of soft budget constraints: how public debt affects hospital performance in Austria," LSE Research Online Documents on Economics 116865, London School of Economics and Political Science, LSE Library.
    20. See, Kok Fong & Ng, Ying Chu, 2021. "Do hospital reform and ownership matter to Shenzhen hospitals in China? A productivity analysis," Economic Analysis and Policy, Elsevier, vol. 72(C), pages 145-155.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:ijhplm:v:35:y:2020:i:5:p:1111-1126. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www.blackwellpublishing.com/journal.asp?ref=0749-6753 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.