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Development and enrolee satisfaction with basic medical insurance in China: A systematic review and stratified cluster sampling survey

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  • Limei Jing
  • Ru Chen
  • Lisa Jing
  • Yun Qiao
  • Jiquan Lou
  • Jing Xu
  • Junwei Wang
  • Wen Chen
  • Xiaoming Sun

Abstract

Basic Medical Insurance (BMI) has changed remarkably over time in China because of health reforms that aim to achieve universal coverage and better health care with adequate efforts by increasing subsidies, reimbursement, and benefits. In this paper, we present the development of BMI, including financing and operation, with a systematic review. Meanwhile, Pudong New Area in Shanghai was chosen as a typical BMI sample for its coverage and management; a stratified cluster sampling survey together with an ordinary logistic regression model was used for the analysis. Enrolee satisfaction and the factors associated with enrolee satisfaction with BMI were analysed. We found that the reenrolling rate superficially improved the BMI coverage and nearly achieved universal coverage. However, BMI funds still faced dual contradictions of fund deficit and insured under compensation, and a long‐term strategy is needed to realize the integration of BMI schemes with more homogeneous coverage and benefits. Moreover, Urban Resident Basic Medical Insurance participants reported a higher rate of dissatisfaction than other participants. The key predictors of the enrolees' satisfaction were awareness of the premium and compensation, affordability of out‐of‐pocket costs, and the proportion of reimbursement. These results highlight the importance that the Chinese government takes measures, such as strengthening BMI fund management, exploring mixed payment methods, and regulating sequential medical orders, to develop an integrated medical insurance system of universal coverage and vertical equity while simultaneously improving enrolee satisfaction.

Suggested Citation

  • Limei Jing & Ru Chen & Lisa Jing & Yun Qiao & Jiquan Lou & Jing Xu & Junwei Wang & Wen Chen & Xiaoming Sun, 2017. "Development and enrolee satisfaction with basic medical insurance in China: A systematic review and stratified cluster sampling survey," International Journal of Health Planning and Management, Wiley Blackwell, vol. 32(3), pages 285-298, July.
    • Handle: RePEc:bla:ijhplm:v:32:y:2017:i:3:p:285-298
    DOI: 10.1002/hpm.2430
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    References listed on IDEAS

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    1. Wanchuan Lin & Gordon G. Liu & Gang Chen, 2009. "The Urban Resident Basic Medical Insurance: a landmark reform towards universal coverage in China," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 83-96, July.
    2. Gang Chen & Gordon Liu & Fei Xu, 2014. "The Impact of the Urban Resident Basic Medical Insurance on Health Services Utilisation in China," PharmacoEconomics, Springer, vol. 32(3), pages 277-292, March.
    3. Limei Jing & Jie Bai & Xiaoming Sun & David Zakus & Jiquan Lou & Ming Li & Qunfang Zhang & Yuehong Zhuang, 2016. "NRCMS capitation reform and effect evaluation in Pudong New Area of Shanghai," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(3), pages 131-157, July.
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    1. Tong Liu & Yufei Gao & Hui Li & Liping Zhang & Jiangjie Sun, 2022. "Analysis of the Operational Efficiency of Basic Medical Insurance for Urban and Rural Residents: Based on a Three-Stage DEA Model," IJERPH, MDPI, vol. 19(21), pages 1-20, October.
    2. Xinxin Peng & Xiaolei Tang & Yijun Chen & Jinghua Zhang, 2021. "Ranking the Healthcare Resource Factors for Public Satisfaction with Health System in China—Based on the Grey Relational Analysis Models," IJERPH, MDPI, vol. 18(3), pages 1-13, January.
    3. Jianqiang Xu & Juan Zheng & Lingzhong Xu & Hongtao Wu, 2021. "Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage," IJERPH, MDPI, vol. 18(2), pages 1-15, January.

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