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Benefits Associated with China’s Social Health Insurance Schemes: Trend Analysis and Associated Factors Since Health Reform

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  • Wanyue Dong

    (School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing 210023, China)

  • Anthony B. Zwi

    (School of Social Sciences, Faculty of Arts and Social Sciences, The University of New South Wales, Kensington 2052, Australia)

  • Ruhai Bai

    (School of Public Affairs, Nanjing University of Science and Technology, Nanjing 210094, China)

  • Chi Shen

    (School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China)

  • Jianmin Gao

    (School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China)

Abstract

With the deepening of health insurance reform in China, the integration of social health insurance schemes was put on the agenda. This paper aims to illustrate the achievements and the gaps in integration by demonstrating the trends in benefits available from the three social health insurance schemes, as well as the influencing factors. Data were drawn from the three waves of the China Health and Nutrition Survey (2009, 2011, 2015) undertaken since health reforms commenced. χ 2 , Kruskal–Wallis test, and the Two-Part model were employed in the analysis. The overall reimbursement rate of the Urban Employee Basic Medical Insurance (UEBMI) is higher than that of Urban Resident Basic Medical Insurance (URBMI) or the New Rural Cooperative Medical Scheme (NRCMS) ( p < 0.001), but the gap has narrowed since health reform began in 2009. Both the outpatient and inpatient reimbursement amounts have increased through the URBMI and NRCMS. Illness severity, higher institutional level, and inpatient service were associated with significant increases in the amount of reimbursement received across the three survey waves. The health reform improved benefits covered by the URBMI and NRCMS, but gaps with the UEBMI still exist. The government should consider more the release of health benefits and how to lead toward healthcare equity.

Suggested Citation

  • Wanyue Dong & Anthony B. Zwi & Ruhai Bai & Chi Shen & Jianmin Gao, 2021. "Benefits Associated with China’s Social Health Insurance Schemes: Trend Analysis and Associated Factors Since Health Reform," IJERPH, MDPI, vol. 18(11), pages 1-14, May.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:11:p:5672-:d:562179
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    References listed on IDEAS

    as
    1. William C. Hsiao & R. Paul Shaw, 2007. "Social Health Insurance for Developing Nations," World Bank Publications - Books, The World Bank Group, number 6860.
    2. David Mark Dror, 2018. "What Factors Affect Voluntary Uptake of Community-based Health Insurance Schemes in Lowand Middle-Income Countries? A Systematic Review and Meta-Analysis," World Scientific Book Chapters, in: Financing Micro Health Insurance Theory, Methods and Evidence, chapter 14, pages 271-306, World Scientific Publishing Co. Pte. Ltd..
    3. World Bank, 2010. "The Path to Integrated Insurance Systems in China," World Bank Publications - Reports 27719, The World Bank Group.
    4. Zhang, Anwen & Nikoloski, Zlatko & Mossialos, Elias, 2017. "Does health insurance reduce out-of-pocket expenditure? Heterogeneity among China's middle-aged and elderly," Social Science & Medicine, Elsevier, vol. 190(C), pages 11-19.
    5. Yip, Winnie & Hsiao, William, 2009. "China's health care reform: A tentative assessment," China Economic Review, Elsevier, vol. 20(4), pages 613-619, December.
    6. Dong, Keyong, 2009. "Medical insurance system evolution in China," China Economic Review, Elsevier, vol. 20(4), pages 591-597, December.
    7. Tan, Si Ying & Wu, Xun & Yang, Wei, 2019. "Impacts of the type of social health insurance on health service utilisation and expenditures: implications for a unified system in China," Health Economics, Policy and Law, Cambridge University Press, vol. 14(4), pages 468-486, October.
    8. Kondo, Ayako & Shigeoka, Hitoshi, 2013. "Effects of universal health insurance on health care utilization, and supply-side responses: Evidence from Japan," Journal of Public Economics, Elsevier, vol. 99(C), pages 1-23.
    9. 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.
    10. Qingyue Meng & Ling Xu, 2014. "Monitoring and Evaluating Progress towards Universal Health Coverage in China," PLOS Medicine, Public Library of Science, vol. 11(9), pages 1-3, September.
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