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Under regional characteristics of rural China: a clearer view on the performance of the New Rural Cooperative Medical Scheme

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  • Dan Liu
  • Daniel Tsegai
  • David Litaker
  • Joachim Braun

Abstract

The New Cooperative Medical Scheme (NCMS) was implemented in 2003 in response to the poor state of health care in rural China. Considering the substantial differences in regional socioeconomics, preferences for health care needs, and concurrent implementation of other health-related policies, the extent to which the impact of the NCMS differs in rural communities across China is unclear. The objective of this paper, therefore, was to explore the variation in the determinants of household enrolment and the impact of enrolment on health care utilization and medical expenditures in three large geographic regions in China. A quasi-experiment study was designed based on the panel data of the China Health and Nutrition Survey. The bounding approach was used to conduct a robust check of impact estimation under the assumption of unobserved bias. A major finding is that household income plays no significant role for enrolment, which indicates the equity of program coverage in income terms. However, regional circumstances matter. In the generally poorer western regions, households with a high ratio of migrant workers are less attracted to the NCMS program, and adoption of the program is related to the regional infrastructure environment variables in the eastern and western regions. The NCMS has improved medical care utilization for poor income groups and regions (western regions). The NCMS’s impact on reducing the incidence of catastrophic expenditures is not shown for all regions. Copyright Springer Science+Business Media New York 2015

Suggested Citation

  • Dan Liu & Daniel Tsegai & David Litaker & Joachim Braun, 2015. "Under regional characteristics of rural China: a clearer view on the performance of the New Rural Cooperative Medical Scheme," International Journal of Health Economics and Management, Springer, vol. 15(4), pages 407-431, December.
    • Handle: RePEc:kap:ijhcfe:v:15:y:2015:i:4:p:407-431
    DOI: 10.1007/s10754-015-9175-z
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    Cited by:

    1. Dawei Zhu & Xuefeng Shi & Stephen Nicholas & Ping He, 2020. "Regional disparities in health care resources in traditional Chinese medicine county hospitals in China," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-13, January.
    2. Jiajing Li & Yanran Huang & Stephen Nicholas & Jian Wang, 2019. "China’s New Cooperative Medical Scheme’s Impact on the Medical Expenses of Elderly Rural Migrants," IJERPH, MDPI, vol. 16(24), pages 1-11, December.

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    More about this item

    Keywords

    Regional characteristics of rural China; Health care access; Health care expenditure; Propensity score matching; Bounding approach; D12; H55; C23; C14; I18;
    All these keywords.

    JEL classification:

    • D12 - Microeconomics - - Household Behavior - - - Consumer Economics: Empirical Analysis
    • H55 - Public Economics - - National Government Expenditures and Related Policies - - - Social Security and Public Pensions
    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • C14 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Semiparametric and Nonparametric Methods: General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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