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Health‐seeking behavior and hospital choice in China's New Cooperative Medical System

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  • Philip H. Brown
  • Caroline Theoharides

Abstract

Since the dissolution of the Rural Cooperative Medical System at the end of the commune period, illness has emerged as a leading cause of poverty in rural China. To address the poor state of health care, the Chinese government unveiled the New Cooperative Medical System in 2002. Because local governments have been given significant control over program design, fundamental characteristics of the program vary from one county to the next. These differences may influence the decision to seek health care as well as the choice of hospital conditional on that initial decision. In this paper, we use a nested logit model to analyze household survey data from 25 counties to analyze the determinants of such health-seeking behavior. We find that age, the share of household expenditures allocated to food consumption (a measure of relative income), and the presence of other sick people in the household negatively affect the decision to seek health care while disability has a positive influence. Further, conditional on seeking treatment, the reimbursement scheme in place in each county and the average daily expenditure associated with hospitalization strongly influence hospital choice. Copyright (C) 2009 John Wiley & Sons, Ltd.

Suggested Citation

  • Philip H. Brown & Caroline Theoharides, 2009. "Health‐seeking behavior and hospital choice in China's New Cooperative Medical System," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 47-64, July.
  • Handle: RePEc:wly:hlthec:v:18:y:2009:i:s2:p:s47-s64
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    File URL: http://hdl.handle.net/10.1002/hec.1508
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    References listed on IDEAS

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    1. Morey, Edward R. & Sharma, Vijaya R. & Mills, Anne, 2003. "Willingness to pay and determinants of choice for improved malaria treatment in rural Nepal," Social Science & Medicine, Elsevier, vol. 57(1), pages 155-165, July.
    2. Nadja Silberhorn & Yasemin Boztug & Lutz Hildebrandt, 2006. "Estimation with the Nested Logit Model: Specifications and Software Particularities," SFB 649 Discussion Papers SFB649DP2006-017, Sonderforschungsbereich 649, Humboldt University, Berlin, Germany.
    3. Hsiao, William C. L., 1995. "The Chinese health care system: Lessons for other nations," Social Science & Medicine, Elsevier, vol. 41(8), pages 1047-1055, October.
    4. 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.
    5. Wagstaff, Adam & Lindelow, Magnus, 2008. "Can insurance increase financial risk?: The curious case of health insurance in China," Journal of Health Economics, Elsevier, vol. 27(4), pages 990-1005, July.
    6. Dasgupta, Partha & Ray, Debraj, 1986. "Inequality as a Determinant of Malnutrition and Unemployment: Theory," Economic Journal, Royal Economic Society, vol. 96(384), pages 1011-1034, December.
    7. Sepehri, Ardeshir & Simpson, Wayne & Sarma, Sisira, 2006. "The influence of health insurance on hospital admission and length of stay--The case of Vietnam," Social Science & Medicine, Elsevier, vol. 63(7), pages 1757-1770, October.
    8. Karen Eggleston & Yu-Chu Shen & Joseph Lau & Christopher H. Schmid & Jia Chan, 2008. "Hospital ownership and quality of care: what explains the different results in the literature?," Health Economics, John Wiley & Sons, Ltd., vol. 17(12), pages 1345-1362.
    9. James P. Smith, 1999. "Healthy Bodies and Thick Wallets: The Dual Relation between Health and Economic Status," Journal of Economic Perspectives, American Economic Association, vol. 13(2), pages 145-166, Spring.
    10. Zhang, Linxiu & Wang, H. Holly & Rozelle, Scott & Yan, Yuanyuan, 2006. "Insuring Rural China's Health? An Empirical Analysis of China's New Cooperative Medical System," 2006 Annual Meeting, August 12-18, 2006, Queensland, Australia 25586, International Association of Agricultural Economists.
    11. Wang, H. Holly & Rosenman, Robert, 2007. "Perceived need and actual demand for health insurance among rural Chinese residents," China Economic Review, Elsevier, vol. 18(4), pages 373-388.
    12. Hotchkiss, David R., 1998. "The tradeoff between price and quality of services in the Philippines," Social Science & Medicine, Elsevier, vol. 46(2), pages 227-242, January.
    13. Wagstaff, Adam & Lindelow, Magnus & Jun, Gao & Ling, Xu & Juncheng, Qian, 2009. "Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme," Journal of Health Economics, Elsevier, vol. 28(1), pages 1-19, January.
    14. H. Ichoku & Murray Leibbrandt, 2003. "Demand for Healthcare Services in Nigeria: A Multivariate Nested Logit Model," African Development Review, African Development Bank, vol. 15(2‐3), pages 396-424.
    15. Uwe E. Reinhardt, 2000. "Health Care for the Aging Baby Boom: Lessons from Abroad," Journal of Economic Perspectives, American Economic Association, vol. 14(2), pages 71-83, Spring.
    16. Marco Varkevisser & Stéphanie Geest, 2007. "Why do patients bypass the nearest hospital? An empirical analysis for orthopaedic care and neurosurgery in the Netherlands," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(3), pages 287-295, September.
    17. Mengtao Gao & Yang Yao, 2006. "Gender Gaps in Access to Health Care in Rural China," Economic Development and Cultural Change, University of Chicago Press, vol. 55, pages 87-107.
    18. Karen Eggleston & Winnie Yip, 2004. "Hospital Competition under Regulated Prices: Application to Urban Health Sector Reforms in China," International Journal of Health Economics and Management, Springer, vol. 4(4), pages 343-368, December.
    19. Wagstaff, Adam, 2007. "The economic consequences of health shocks: Evidence from Vietnam," Journal of Health Economics, Elsevier, vol. 26(1), pages 82-100, January.
    20. Florian Heiss, 2002. "Structural choice analysis with nested logit models," Stata Journal, StataCorp LP, vol. 2(3), pages 227-252, August.
    21. Wang, Hongman & Gu, Danan & Dupre, Matthew Egan, 2008. "Factors associated with enrollment, satisfaction, and sustainability of the New Cooperative Medical Scheme program in six study areas in rural Beijing," Health Policy, Elsevier, vol. 85(1), pages 32-44, January.
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    Cited by:

    1. Winnie Yip & Adam Wagstaff & William C. Hsiao, 2009. "Economic analysis of China's health care system: turning a new page," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 3-6, July.
    2. Pan, Jay & Qin, Xuezheng & Li, Qian & Messina, Joseph P. & Delamater, Paul L., 2015. "Does hospital competition improve health care delivery in China?," China Economic Review, Elsevier, vol. 33(C), pages 179-199.
    3. Cheung, Diana & Padieu, Ysaline, 2015. "Heterogeneity of the Effects of Health Insurance on Household Savings: Evidence from Rural China," World Development, Elsevier, vol. 66(C), pages 84-103.
    4. Raza, W.A. & Panda, P. & Van de Poel, E. & Dror, D.M. & Bedi, A.S., 2013. "Healthcare Seeking Behavior among Self-help Group Households in Rural Bihar and Uttar Pradesh, India," ISS Working Papers - General Series 50172, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
    5. Li, Li & Lin, Chunqing & Wu, Zunyou & Scott Comulada, W. & Ding, Yingying, 2012. "Regional differences in HIV prevalence and individual attitudes among service providers in China," Social Science & Medicine, Elsevier, vol. 75(2), pages 283-287.
    6. Diana Cheung & Jean-Pierre Laffargue & Ysaline Padieu, 2016. "Insurance of Household Risks and the Rebalancing of the Chinese Economy: Health Insurance, Health Expenses and Household Savings," Pacific Economic Review, Wiley Blackwell, vol. 21(3), pages 381-412, August.
    7. Martine AUDIBERT & Jacky MATHONNAT & Yong HE, 2010. "Income Growth, Price Variation and Health Care Demand: A Mixed Logit Model Applied to Tow-period Comparison in Rural China," Working Papers 201035, CERDI.
    8. Martine AUDIBERT & Jacky MATHONNAT & Aurore PELISSIER & Xiao Xian HUANG & Anning MA & Ningshan CHEN, 2011. "Curative Activities of Township Hospitals in Weifang Prefecture, China: An Analysis of Environmental and Supply-Side Determinants," Working Papers 201130, CERDI.
    9. Aurore Pelissier & Martine Audibert & Jacky Mathonnat & Xiao Xian Huang & Ningshan Chen & Anning Ma, 2012. "Curative Activities of Township Hospitals in Weifang Prefecture, China: An Analysis of Environmental and Supply-Side Determinants," Post-Print halshs-00640742, HAL.
    10. Zhiyuan Hou & Ellen Van de Poel & Eddy Van Doorslaer & Baorong Yua & Qingyue Menge, 2012. "Effects of NCMS Coverage on Access to Care and Financial Protection in China," Tinbergen Institute Discussion Papers 12-039/3, Tinbergen Institute.

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