Advanced Search
MyIDEAS: Login to save this article or follow this journal

Catastrophic medical payment and financial protection in rural China: evidence from the New Cooperative Medical Scheme in Shandong Province

Contents:

Author Info

  • Xiaoyun Sun

    (Health Department of Shandong Province, Jinan, China)

  • Sukhan Jackson

    (School of Economics, University of Queensland, St Lucia, Brisbane, Australia)

  • Gordon Carmichael

    (National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia)

  • Adrian C. Sleigh

    (National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia)

Abstract

Objective: To measure the impact of China's New Cooperative Medical Scheme (NCMS) on catastrophic medical payments of rural households in Linyi County, Shandong Province. Method: In 2005, from a stratified cluster sample of 3101 rural households, we identified 375 households that might be at risk of catastrophic payments by searching through NCMS claims and interviewing key informants. We interviewed these 375 households and confirmed that 231 had had catastrophic payments (≥ 40% of the households' capacity to pay; CTP) during 2004. A validity test of our screening method found another eight cases among immediate neighbours of these 375 households; by extrapolation, we obtained an adjusted total of 289 catastrophic households in the sample of 3101. We measured the impact of the NCMS on hardship alleviation by counterfactual analysis, comparing catastrophic payments before and after NCMS reimbursements. Result: The effect was twofold. Before NCMS intervention 8.98% of Linyi population had had catastrophic out-of-pocket payments compared with 8.25% after reimbursements. Catastrophic severity for households remaining in catastrophe after reimbursement dropped by 18.7% to an average of 6.34 times the household's CTP. Conclusion: Out-of-pocket medical payments remain a burden for rural households. Financial protection from the NCMS, with an average reimbursement of 17.8%, was modest and should be restructured to provide better benefits that are targeted to those in most need. Copyright © 2008 John Wiley & Sons, Ltd.

Download Info

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
File URL: http://hdl.handle.net/10.1002/hec.1346
File Function: Link to full text; subscription required
Download Restriction: no

Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 18 (2009)
Issue (Month): 1 ()
Pages: 103-119

as in new window
Handle: RePEc:wly:hlthec:v:18:y:2009:i:1:p:103-119

Contact details of provider:
Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

Related research

Keywords:

References

References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
as in new window
  1. Liu, Yuanli & Hu, Shanlian & Fu, Wei & Hsiao, William C., 1996. "Is community financing necessary and feasible for rural China?," Health Policy, Elsevier, Elsevier, vol. 38(3), pages 155-171, December.
  2. McIntyre, Diane & Thiede, Michael & Dahlgren, Göran & Whitehead, Margaret, 2006. "What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts?," Social Science & Medicine, Elsevier, Elsevier, vol. 62(4), pages 858-865, February.
  3. Yingyi Qian, 1988. "Urban and Rural Household Saving in China," IMF Staff Papers, Palgrave Macmillan, vol. 35(4), pages 592-627, December.
  4. Waters, Hugh R. & Anderson, Gerard F. & Mays, Jim, 2004. "Measuring financial protection in health in the United States," Health Policy, Elsevier, Elsevier, vol. 69(3), pages 339-349, September.
  5. Carrin, Guy & Ron, Aviva & Hui, Yang & Hong, Wang & Tuohong, Zhang & Licheng, Zhang & Shuo, Zhang & Yide, Ye & Jiaying, Chen & Qicheng, Jiang & Zhaoyang, Zhang & Jun, Yu & Xuesheng, Li, 1999. "The reform of the rural cooperative medical system in the People's Republic of China: interim experience in 14 pilot counties," Social Science & Medicine, Elsevier, Elsevier, vol. 48(7), pages 961-972, April.
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 in new window

Cited by:
  1. Niëns, L.M. & Brouwer, W.B.F., 2013. "Measuring the affordability of medicines: Importance and challenges," Health Policy, Elsevier, Elsevier, vol. 112(1), pages 45-52.
  2. Richard Herd, 2013. "The evolution of China’s social policies," Economic Change and Restructuring, Springer, Springer, vol. 46(1), pages 109-141, March.
  3. Martine Audibert & Xiao Xian Huang & Jacky Mathonnat & Aurore Pelissier & Ningshan Chen & Anning Ma, 2012. "Curative Activities of Township Hospitals in Weifang Prefecture, China: An Analysis of Environmental and Supply-Side Determinants," Working Papers, HAL halshs-00640742, HAL.
  4. Adam Wagstaff & Winnie Yip & Magnus Lindelow & William C. Hsiao, 2009. "China's health system and its reform: a review of recent studies," Health Economics, John Wiley & Sons, Ltd., John Wiley & Sons, Ltd., vol. 18(S2), pages S7-S23, July.
  5. Liu, Hong & Zhao, Zhong, 2012. "Impact of China's Urban Resident Basic Medical Insurance on Health Care Utilization and Expenditure," IZA Discussion Papers 6768, Institute for the Study of Labor (IZA).
  6. Mebratie, A.D. & Sparrow, R.A. & Alemu, G. & Bedi, A.S., 2013. "Community-Based Health Insurance Schemes," ISS Working Papers - General Series, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague 568, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
  7. Caballes, Alvin B. & Söllner, Walter & Nañagas, Juan, 2012. "Financial protection mechanisms for inpatients at selected Philippine hospitals," Social Science & Medicine, Elsevier, Elsevier, vol. 75(10), pages 1820-1827.
  8. Xiong, Juyang & Hipgrave, David & Myklebust, Karoline & Guo, Sufang & Scherpbier, Robert W. & Tong, Xuetao & Yao, Lan & Moran, Andrew E., 2013. "Child health security in China: A survey of child health insurance coverage in diverse areas of the country," Social Science & Medicine, Elsevier, Elsevier, vol. 97(C), pages 15-19.
  9. Meiling Ying & Zaichao Du, 2012. "The effects of medical insurance on durables consumption in rural China," China Agricultural Economic Review, Emerald Group Publishing, Emerald Group Publishing, vol. 4(2), pages 176-187, May.
  10. Mohammad Hajizadeh & Hong Nghiem, 2011. "Out-of-pocket expenditures for hospital care in Iran: who is at risk of incurring catastrophic payments?," International Journal of Health Care Finance and Economics, Springer, Springer, vol. 11(4), pages 267-285, December.

Lists

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

Statistics

Access and download statistics

Corrections

When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:18:y:2009:i:1:p:103-119. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Wiley-Blackwell Digital Licensing) or (Christopher F. Baum).

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 references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link 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 profile, as there may be some citations waiting for confirmation.

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