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Effects of Rural Mutual Health Care on outpatient service utilization in Chinese village medical institutions: evidence from panel data

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  • Zhongliang Zhou
  • Jianmin Gao
  • Qinxiang Xue
  • Xiaowei Yang
  • Ju'e Yan
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    Abstract

    To solve the problem of ‘Kan bing nan, kan bing gui’ (medical treatment is difficult to access and expensive), a Harvard-led research team implemented a community‐based health insurance scheme known as Rural Mutual Health Care (RMHC) in Chinese rural areas from 2004 to 2006. Two major policies adopted by RMHC included insurance coverage of outpatient services (demand‐side policy) and drug policy (supply‐side policy). This paper focuses on the effects of these two policies on outpatient service utilization in Chinese village clinics. The data used in this study are from 3‐year household follow‐up surveys. A generalized negative binomial regression model and a Heckman selection model were constructed using panel data from 2005 to 2007. The results indicate that the price elasticities of demand for outpatient visits and per‐visit outpatient expenses were −1.5 and −0.553, respectively. After implementing the supply‐side policy, outpatient visits and per‐visit outpatient expenses decreased by 94.7 and 55.9%, respectively, controlling for insurance coverage. These findings can be used to make recommendations to the Chinese government on improving the health care system. Copyright (C) 2009 John Wiley & Sons, Ltd.

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    File URL: http://hdl.handle.net/10.1002/hec.1519
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    Bibliographic Info

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

    Volume (Year): 18 (2009)
    Issue (Month): S2 (July)
    Pages: S129-S136

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    Handle: RePEc:wly:hlthec:v:18:y:2009:i:s2:p:s129-s136

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    Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

    Related research

    Keywords: RMHC ; outpatient expense insurance ; eliminate the physicians' profit from drugs ; random effectsmodel ; rural China ; health insurance ; outpatient services ; drug policy ; panel data ;

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    1. Bruce D. Meyer & James X. Sullivan, 2003. "Measuring the Well-Being of the Poor Using Income and Consumption," NBER Working Papers 9760, National Bureau of Economic Research, Inc.
    2. Wagstaff, Adam & Lindelow, Magnus & Jun, Gao & Ling, Xu & Juncheng, Qian, 2009. "Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme," Journal of Health Economics, Elsevier, Elsevier, vol. 28(1), pages 1-19, January.
    3. Eddy van Doorslaer & Xander Koolman & Andrew M. Jones, 2004. "Explaining income-related inequalities in doctor utilisation in Europe," Health Economics, John Wiley & Sons, Ltd., John Wiley & Sons, Ltd., vol. 13(7), pages 629-647.
    4. Wang, Hong & Zhang, Licheng & Hsiao, William, 2006. "Ill health and its potential influence on household consumptions in rural China," Health Policy, Elsevier, Elsevier, vol. 78(2-3), pages 167-177, October.
    5. Heckman, James J, 1979. "Sample Selection Bias as a Specification Error," Econometrica, Econometric Society, Econometric Society, vol. 47(1), pages 153-61, January.
    6. Xingyuan, Gu & Bloom, Gerald & Shenglan, Tang & Yingya, Zhu & Shouqi, Zhou & Xingbao, Chen, 1993. "Financing health care in rural China: Preliminary report of a nationwide study," Social Science & Medicine, Elsevier, Elsevier, vol. 36(4), pages 385-391, February.
    7. Kim, Han Joong & Chung, Woojin & Lee, Sang Gyu, 2004. "Lessons from Korea's pharmaceutical policy reform: the separation of medical institutions and pharmacies for outpatient care," Health Policy, Elsevier, Elsevier, vol. 68(3), pages 267-275, June.
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    Cited by:
    1. Winnie Yip & Adam Wagstaff & William C. Hsiao, 2009. "Economic analysis of China's health care system: turning a new page," Health Economics, John Wiley & Sons, Ltd., John Wiley & Sons, Ltd., vol. 18(S2), pages S3-S6, July.
    2. Fink, Günther & Robyn, Paul Jacob & Sié, Ali & Sauerborn, Rainer, 2013. "Does health insurance improve health?," Journal of Health Economics, Elsevier, Elsevier, vol. 32(6), pages 1043-1056.
    3. Zhou, Zhongliang & Su, Yanfang & Gao, Jianmin & Xu, Ling & Zhang, Yaoguang, 2011. "New estimates of elasticity of demand for healthcare in rural China," Health Policy, Elsevier, Elsevier, vol. 103(2), pages 255-265.
    4. Robyn, Paul Jacob & Fink, Günther & Sié, Ali & Sauerborn, Rainer, 2012. "Health insurance and health-seeking behavior: Evidence from a randomized community-based insurance rollout in rural Burkina Faso," Social Science & Medicine, Elsevier, Elsevier, vol. 75(4), pages 595-603.

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