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Examining the level and distribution of catastrophic health expenditure from 2013 to 2018: A province-level study in China

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  • Chen, Mingsheng
  • Xu, Lizheng
  • Si, Lei
  • Wang, Zhonghua
  • Jan, Stephen

Abstract

Since 2018, 96.8% of China's population has received universal health coverage; however, changes in the general population's level and distribution of catastrophic health expenditure (CHE) remain unclear. This study aims to quantify the incidence and intensity of CHE by adopting a multistage stratified random sampling procedure that used a threshold of 25% of non-food household expenditures. We use the concentration index to measure the extent of inequality in CHE. Furthermore, logistic regression was applied to identify the sociodemographic and economic determinants of CHE, thereby revealing that the incidence and intensity of CHE increased between 2013 and 2018. A greater concentration of CHE was identified in low-income households. Our results imply that expanding the existing public health insurance benefit packages and introducing universal supplementary private insurance to more population segments is necessary.

Suggested Citation

  • 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).
    • Handle: RePEc:eee:ecmode:v:121:y:2023:i:c:s0264999323000457
    DOI: 10.1016/j.econmod.2023.106233
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    More about this item

    Keywords

    Catastrophic health expenditure; Health insurance; Out-of-pocket payments; Universal health coverage; Determinants;
    All these keywords.

    JEL classification:

    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I32 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Measurement and Analysis of Poverty
    • P36 - Political Economy and Comparative Economic Systems - - Socialist Institutions and Their Transitions - - - Consumer Economics; Health; Education and Training; Welfare, Income, Wealth, and Poverty

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