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Health‐seeking behavior and hospital choice in China's New Cooperative Medical System

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  • Philip H. Brown
  • Caroline Theoharides

Abstract

Since the dissolution of the Rural Cooperative Medical System at the end of the commune period, illness has emerged as a leading cause of poverty in rural China. To address the poor state of health care, the Chinese government unveiled the New Cooperative Medical System in 2002. Because local governments have been given significant control over program design, fundamental characteristics of the program vary from one county to the next. These differences may influence the decision to seek health care as well as the choice of hospital conditional on that initial decision. In this paper, we use a nested logit model to analyze household survey data from 25 counties to analyze the determinants of such health‐seeking behavior. We find that age, the share of household expenditures allocated to food consumption (a measure of relative income), and the presence of other sick people in the household negatively affect the decision to seek health care while disability has a positive influence. Further, conditional on seeking treatment, the reimbursement scheme in place in each county and the average daily expenditure associated with hospitalization strongly influence hospital choice. Copyright © 2009 John Wiley & Sons, Ltd.

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  • Philip H. Brown & Caroline Theoharides, 2009. "Health‐seeking behavior and hospital choice in China's New Cooperative Medical System," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 47-64, July.
    • Handle: RePEc:wly:hlthec:v:18:y:2009:i:s2:p:s47-s64
    DOI: 10.1002/hec.1508
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    Cited by:

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    2. Alfred Kechia Mukong & Justine Burns, 2019. "Bargaining Power within Couples and Health Care Provider Choice in Tanzania," African Development Review, African Development Bank, vol. 31(3), pages 380-392, September.
    3. Pan, Jay & Qin, Xuezheng & Li, Qian & Messina, Joseph P. & Delamater, Paul L., 2015. "Does hospital competition improve health care delivery in China?," China Economic Review, Elsevier, vol. 33(C), pages 179-199.
    4. 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.
    5. Raza, W.A. & Panda, P. & Van de Poel, E. & Dror, D.M. & Bedi, A.S., 2013. "Healthcare Seeking Behavior among Self-help Group Households in Rural Bihar and Uttar Pradesh, India," ISS Working Papers - General Series 50172, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
    6. Li, Li & Lin, Chunqing & Wu, Zunyou & Scott Comulada, W. & Ding, Yingying, 2012. "Regional differences in HIV prevalence and individual attitudes among service providers in China," Social Science & Medicine, Elsevier, vol. 75(2), pages 283-287.
    7. Qi Liu & Jin Liu & Shuntian Sui, 2020. "Public Medical Insurance and Healthcare Utilization and Expenditures of Older with Chronic Diseases in Rural China: Evidence from NRCMS," IJERPH, MDPI, vol. 17(20), pages 1-15, October.
    8. Martine Audibert & Yong He & Jacky Mathonnat, 2011. "Income Growth, Price Variation and Health Care Demand: A Mixed Logit Model Applied to Tow-period Comparison in Rural China," CERDI Working papers halshs-00552192, HAL.
    9. Diana Cheung & Jean-Pierre Laffargue & Ysaline Padieu, 2016. "Insurance of Household Risks and the Rebalancing of the Chinese Economy: Health Insurance, Health Expenses and Household Savings," Pacific Economic Review, Wiley Blackwell, vol. 21(3), pages 381-412, August.
    10. Honora Smith & Christine Currie & Pornpimol Chaiwuttisak & Andreas Kyprianou, 2018. "Patient choice modelling: how do patients choose their hospitals?," Health Care Management Science, Springer, vol. 21(2), pages 259-268, June.
    11. Yanchen Liu & Yingchun Chen & Xueyan Cheng & Yan Zhang, 2020. "Performance and Sociodemographic Determinants of Excess Outpatient Demand of Rural Residents in China: A Cross-Sectional Study," IJERPH, MDPI, vol. 17(16), pages 1-14, August.
    12. Martine AUDIBERT & Jacky MATHONNAT & Yong HE, 2010. "Income Growth, Price Variation and Health Care Demand: A Mixed Logit Model Applied to Tow-period Comparison in Rural China," Working Papers 201035, CERDI.
    13. 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).
    14. Yun Liu & Qingxia Kong & Shasha Yuan & Joris van de Klundert, 2018. "Factors influencing choice of health system access level in China: A systematic review," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-21, August.
    15. Martine AUDIBERT & Jacky MATHONNAT & Aurore PELISSIER & Xiao Xian HUANG & Anning MA & Ningshan CHEN, 2011. "Curative Activities of Township Hospitals in Weifang Prefecture, China: An Analysis of Environmental and Supply-Side Determinants," Working Papers 201130, CERDI.
    16. Wang, H. & Guan, H. & Boswell, M., 2018. "Health Seeking Behavior among Rural Left-behind Children: Evidence from a Randomized Controlled Trial in China," 2018 Conference, July 28-August 2, 2018, Vancouver, British Columbia 276955, International Association of Agricultural Economists.
    17. Li, Yan, 2022. "Social care for disabled elderly women in urban China: The roles of the community," Social Science & Medicine, Elsevier, vol. 314(C).
    18. Shen, Menghan & He, Wen & Li, Linyan, 2020. "Incentives to use primary care and their impact on healthcare utilization: Evidence using a public health insurance dataset in China," Social Science & Medicine, Elsevier, vol. 255(C).
    19. Zhiyuan Hou & Ellen Van de Poel & Eddy Van Doorslaer & Baorong Yua & Qingyue Menge, 2012. "Effects of NCMS Coverage on Access to Care and Financial Protection in China," Tinbergen Institute Discussion Papers 12-039/3, Tinbergen Institute.
    20. Hao‐Miao Li & Ying‐Chun Chen & Hong‐Xia Gao & Yan Zhang & Dai Su & Jing‐Jing Chang & Di Jiang & Xiao‐Mei Hu & Shi‐Han Lei, 2019. "Changes in inpatients' distribution and benefits under institution level–based quota payment for specific diseases in rural China: An interrupted time‐series analysis," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 436-446, January.

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