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Financing health care in rural China: Preliminary report of a nationwide study

Author

Listed:
  • Xingyuan, Gu
  • Bloom, Gerald
  • Shenglan, Tang
  • Yingya, Zhu
  • Shouqi, Zhou
  • Xingbao, Chen

Abstract

One unforeseen consequence of the change from collective to household production in rural China has been that the financial basis of the rural health services has been eroded. The majority of peasants now pay for health care on a fee-for-service basis. A major initiative aimed at the establishment of prepayment schemes for funding rural health services is underway. A nationwide survey which compared health utilization and expenditure under different financing mechanisms was carried out in 1988. This paper presents the preliminary findings of that study. There is evidence that hospital charges were a barrier to inpatient care for those not covered by an insurance scheme. The data were less clearcut with regard to access to outpatient care. There is a need for further study which focuses on poor households and those living in remote villages. The study found that drug charges are an important source of revenue for the rural health services. The impact of this on prescription practices is an area which requires additional research. The cost of rural health services was relatively low. It is feasible to finance them almost entirely out of local resources in the more developed regions. The situation in the poorer provinces is more complicated. In spite of the fact that average health expenditure was almost 5% of household income in 1988, there was evidence of lack of access. This suggests that it may be more difficult to develop prepayment schemes to cover the full range of rural health services in the less developed regions.

Suggested Citation

  • 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, vol. 36(4), pages 385-391, February.
  • Handle: RePEc:eee:socmed:v:36:y:1993:i:4:p:385-391
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    Citations

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    Cited by:

    1. Hong Wang & Winnie Yip & Licheng Zhang & William C. Hsiao, 2009. "The impact of rural mutual health care on health status: evaluation of a social experiment in rural China," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 65-82, July.
    2. Zhongliang Zhou & Jianmin Gao & Qinxiang Xue & Xiaowei Yang & Ju'e Yan, 2009. "Effects of Rural Mutual Health Care on outpatient service utilization in Chinese village medical institutions: evidence from panel data," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 129-136, July.
    3. Chengzhi Yi & Linsha Wei & Cuihong Long, 2023. "Does medical insurance improve health? An empirical analysis from China," International Journal of Health Planning and Management, Wiley Blackwell, vol. 38(3), pages 829-846, May.
    4. Zhang, Licheng & Wang, Hong & Wang, Lushang & Hsiao, William, 2006. "Social capital and farmer's willingness-to-join a newly established community-based health insurance in rural China," Health Policy, Elsevier, vol. 76(2), pages 233-242, April.
    5. Hong Wang & Licheng Zhang & Heng-fu Zou, 2006. "Health Services in Rural China," CEMA Working Papers 563, China Economics and Management Academy, Central University of Finance and Economics.
    6. Matthew Jowett, 2004. "Theoretical insights into the development of health insurance in low-income countries," Working Papers 188chedp, Centre for Health Economics, University of York.
    7. You, Xuedan & Kobayashi, Yasuki, 2009. "The new cooperative medical scheme in China," Health Policy, Elsevier, vol. 91(1), pages 1-9, June.
    8. Yu Rong Yang & Gail M Williams & Philip S Craig & Donald P McManus, 2010. "Impact of Increased Economic Burden Due to Human Echinococcosis in an Underdeveloped Rural Community of the People's Republic of China," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 4(9), pages 1-7, September.
    9. Dong, Hengjin & Bogg, Lennart & Rehnberg, Clas & Diwan, Vinod, 1999. "Association between health insurance and antibiotics prescribing in four counties in rural China," Health Policy, Elsevier, vol. 48(1), pages 29-45, July.
    10. Zhang, Licheng & Wang, Hong, 2008. "Dynamic process of adverse selection: Evidence from a subsidized community-based health insurance in rural China," Social Science & Medicine, Elsevier, vol. 67(7), pages 1173-1182, October.
    11. Liu, Yuanli & Hu, Shanlian & Fu, Wei & Hsiao, William C., 1996. "Is community financing necessary and feasible for rural China?," Health Policy, Elsevier, vol. 38(3), pages 155-171, December.

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