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Effects of Rural Mutual Health Care on outpatient service utilization in Chinese village medical institutions: evidence from panel data

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  • Zhongliang Zhou
  • Jianmin Gao
  • Qinxiang Xue
  • Xiaowei Yang
  • Ju'e Yan

Abstract

To solve the problem of ‘Kan bing nan, kan bing gui’ (medical treatment is difficult to access and expensive), a Harvard‐led research team implemented a community‐based health insurance scheme known as Rural Mutual Health Care (RMHC) in Chinese rural areas from 2004 to 2006. Two major policies adopted by RMHC included insurance coverage of outpatient services (demand‐side policy) and drug policy (supply‐side policy). This paper focuses on the effects of these two policies on outpatient service utilization in Chinese village clinics. The data used in this study are from 3‐year household follow‐up surveys. A generalized negative binomial regression model and a Heckman selection model were constructed using panel data from 2005 to 2007. The results indicate that the price elasticities of demand for outpatient visits and per‐visit outpatient expenses were −1.5 and −0.553, respectively. After implementing the supply‐side policy, outpatient visits and per‐visit outpatient expenses decreased by 94.7 and 55.9%, respectively, controlling for insurance coverage. These findings can be used to make recommendations to the Chinese government on improving the health care system. Copyright © 2009 John Wiley & Sons, Ltd.

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  • 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.
    • Handle: RePEc:wly:hlthec:v:18:y:2009:i:s2:p:s129-s136
    DOI: 10.1002/hec.1519
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    2. Timothy Powell‐Jackson & Winnie Chi‐Man Yip & Wei Han, 2015. "Realigning Demand and Supply Side Incentives to Improve Primary Health Care Seeking in Rural China," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 755-772, June.
    3. Lan Thi Thu Phan & Yusuke Jinnai, 2018. "Does health insurance matter in the hospital? New evidence from patient-level medical records in Vietnam," Working Papers EMS_2018_01, Research Institute, International University of Japan.
    4. Robyn, Paul Jacob & Fink, Günther & Sié, Ali & Sauerborn, Rainer, 2012. "Health insurance and health-seeking behavior: Evidence from a randomized community-based insurance rollout in rural Burkina Faso," Social Science & Medicine, Elsevier, vol. 75(4), pages 595-603.
    5. Fink, Günther & Robyn, Paul Jacob & Sié, Ali & Sauerborn, Rainer, 2013. "Does health insurance improve health?," Journal of Health Economics, Elsevier, vol. 32(6), pages 1043-1056.
    6. Zhiyuan Hou & Ellen Van de Poel & Eddy Van Doorslaer & Baorong Yu & Qingyue Meng, 2014. "Effects Of Ncms On Access To Care And Financial Protection In China," Health Economics, John Wiley & Sons, Ltd., vol. 23(8), pages 917-934, August.
    7. Zhou, Zhongliang & Su, Yanfang & Gao, Jianmin & Xu, Ling & Zhang, Yaoguang, 2011. "New estimates of elasticity of demand for healthcare in rural China," Health Policy, Elsevier, vol. 103(2), pages 255-265.
    8. Junfang Xu & Jian Wang & Madeleine King & Ruiyun Liu & Fenghua Yu & Jinshui Xing & Lei Su & Mingshan Lu, 2018. "Rural–urban disparities in the utilization of mental health inpatient services in China: the role of health insurance," International Journal of Health Economics and Management, Springer, vol. 18(4), pages 377-393, December.
    9. Yuyan Qian & Jianmin Gao & Zhongliang Zhou & Ju’e Yan & Yongjian Xu & Xiaowei Yang & Yanli Li, 2017. "An equity analysis of health examination service utilization by women from underdeveloped areas in western China," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-14, October.
    10. Chengxu Long & Ruoxi Wang & Da Feng & Lu Ji & Zhanchun Feng & Shangfeng Tang, 2020. "Social Support and Health Services Use in People Aged over 65 Years Migrating within China: A Cross-Sectional Study," IJERPH, MDPI, vol. 17(13), pages 1-14, June.

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