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Effect of Critical Illness Insurance on Household Catastrophic Health Expenditure: The Latest Evidence from the National Health Service Survey in China

Author

Listed:
  • Anqi Li

    (School of Health Policy Management, Nanjing Medical University, Nanjing 211166, China)

  • Yeliang Shi

    (School of Health Policy Management, Nanjing Medical University, Nanjing 211166, China)

  • Xue Yang

    (School of Health Policy Management, Nanjing Medical University, Nanjing 211166, China)

  • Zhonghua Wang

    (School of Health Policy Management, Nanjing Medical University, Nanjing 211166, China
    Creative Health Policy Research Group, Nanjing Medical University, Nanjing 211166, China
    Center for Global Health, Nanjing Medical University, Nanjing 211166, China)

Abstract

Background: China fully implemented the critical illness insurance (CII) program in 2016 to alleviate the economic burden of diseases and reduce catastrophic health expenditure (CHE). With an aging society, it is necessary to analyze the extent of CHE among Chinese households and explore the effect of CII and other associated factors on CHE. Methods: Data were derived from the Sixth National Health Service Survey (NHSS, 2018) in Jiangsu Province. The incidence and intensity of CHE were calculated with a sample of 3660 households in urban and rural areas in Jiangsu Province, China. Logistic regression and multiple linear regression models were used for estimating the effect of CII and related factors on CHE. Results: The proportion of households with no one insured by CII was 50.08% (1833). At each given threshold, from 20% to 60%, the incidence and intensity were higher in rural households than in urban ones. CII implementation reduced the incidence of CHE but increased the intensity of CHE. Meanwhile, the number of household members insured by CII did not affect CHE incidence but significantly decreased CHE intensity. Socioeconomic factors, such as marital status, education, employment, registered type of household head, household income and size, chronic disease status, and health service utilization, significantly affected household CHE. Conclusions: Policy effort should further focus on appropriate adjustments, such as dynamization of CII lists, medical cost control, increasing the CII coverage rate, and improving the reimbursement level to achieve the ultimate aim of using CII to protect Chinese households against financial risk caused by illness.

Suggested Citation

  • Anqi Li & Yeliang Shi & Xue Yang & Zhonghua Wang, 2019. "Effect of Critical Illness Insurance on Household Catastrophic Health Expenditure: The Latest Evidence from the National Health Service Survey in China," IJERPH, MDPI, vol. 16(24), pages 1-17, December.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:24:p:5086-:d:297462
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    References listed on IDEAS

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    1. Ye Li & Qunhong Wu & Chaojie Liu & Zheng Kang & Xin Xie & Hui Yin & Mingli Jiao & Guoxiang Liu & Yanhua Hao & Ning Ning, 2014. "Catastrophic Health Expenditure and Rural Household Impoverishment in China: What Role Does the New Cooperative Health Insurance Scheme Play?," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-9, April.
    2. Kronenberg, Christoph & Barros, Pedro Pita, 2014. "Catastrophic healthcare expenditure – Drivers and protection: The Portuguese case," Health Policy, Elsevier, vol. 115(1), pages 44-51.
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    Cited by:

    1. Guangsheng Wan & Zixuan Peng & Yufeng Shi & Peter C. Coyte, 2020. "What Are the Determinants of the Decision to Purchase Private Health Insurance in China?," IJERPH, MDPI, vol. 17(15), pages 1-15, July.
    2. 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).
    3. Hongmei Cao & Xinpeng Xu & Hua You & Jinghong Gu & Hongyan Hu & Shan Jiang, 2022. "Healthcare Expenditures among the Elderly in China: The Role of Catastrophic Medical Insurance," IJERPH, MDPI, vol. 19(21), pages 1-20, November.

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