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The impact of rural mutual health care on health status: evaluation of a social experiment in rural China

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  • Hong Wang
  • Winnie Yip
  • Licheng Zhang
  • William C. Hsiao

Abstract

Despite widespread efforts to expand health insurance in developing countries, there is scant evidence as to whether doing so actually improves people's health. This paper aims to fill this gap by evaluating the impact of Rural Mutual Health Care (RMHC), a community-based health insurance scheme, on enrollees' health outcomes. RMHC is a social experiment that was conducted in one of China's western provinces from 2003 to 2006. The RMHC experiment adopted a pre–post treatment‐control study design. This study used panel data collected in 2002, 1 year prior to the intervention, and followed up in 2005, 2 years after the intervention, both in the intervention and control sites. We measured health status using both a 5‐point Categorical Rating Scale and the EQ‐5D instruments. The estimation method used here is difference‐in‐difference combined propensity score matching. The results show that RMHC has a positive effect on the health status of participants. Among the five dimensions of EQ‐5D, RMHC significantly reduces pain/discomfort and anxiety/depression for the general population, and has a positive impact on mobility and usual activity for those over 55‐years old. Our study provides useful policy information on the development of health insurance in developing countries, and also identifies areas where further research is needed. Copyright (C) 2009 John Wiley & Sons, Ltd.

Suggested Citation

  • 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.
  • Handle: RePEc:wly:hlthec:v:18:y:2009:i:s2:p:s65-s82
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    File URL: http://hdl.handle.net/10.1002/hec.1465
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    References listed on IDEAS

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    1. David Card & Carlos Dobkin & Nicole Maestas, 2004. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health Evidence from Medicare," Working Papers WR-197, RAND Corporation.
    2. A. Smith, Jeffrey & E. Todd, Petra, 2005. "Does matching overcome LaLonde's critique of nonexperimental estimators?," Journal of Econometrics, Elsevier, vol. 125(1-2), pages 305-353.
    3. 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.
    4. Bruce D. Meyer & James X. Sullivan, 2003. "Measuring the Well-Being of the Poor Using Income and Consumption," NBER Working Papers 9760, National Bureau of Economic Research, Inc.
    5. Xueshan, Feng & Shenglan, Tang & Bloom, Gerald & Segall, Malcolm & Xingyuan, Gu, 1995. "Cooperative medical schemes in contemporary rural China," Social Science & Medicine, Elsevier, vol. 41(8), pages 1111-1118, October.
    6. Wagstaff, Adam & Pradhan, Menno, 2005. "Health insurance impacts on health and nonmedical consumption in a developing country," Policy Research Working Paper Series 3563, The World Bank.
    7. Richard Blundell & Lorraine Dearden & Barbara Sianesi, 2003. "Evaluating the impact of education on earnings in the UK: Models, methods and results from the NCDS," IFS Working Papers W03/20, Institute for Fiscal Studies.
    8. Ravallion, Martin, 2008. "Evaluating Anti-Poverty Programs," Handbook of Development Economics, Elsevier.
    9. 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.
    10. David Card & Carlos Dobkin & Nicole Maestas, 2004. "The Impact of Nearly Universal Insurance Coverage on Health Care Utilization and Health: Evidence from Medicare," NBER Working Papers 10365, National Bureau of Economic Research, Inc.
    11. Guido W. Imbens, 2004. "Nonparametric Estimation of Average Treatment Effects Under Exogeneity: A Review," The Review of Economics and Statistics, MIT Press, vol. 86(1), pages 4-29, February.
    12. Wagstaff, Adam & Yu, Shengchao, 2007. "Do health sector reforms have their intended impacts?: The World Bank's Health VIII project in Gansu province, China," Journal of Health Economics, Elsevier, vol. 26(3), pages 505-535, May.
    13. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1, June.
    14. repec:aph:ajpbhl:1984:74:6:611-614_0 is not listed on IDEAS
    15. Richard Blundell & Lorraine Dearden & Barbara Sianesi, 2005. "Evaluating the effect of education on earnings: models, methods and results from the National Child Development Survey," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 168(3), pages 473-512.
    16. Likwang Chen & Winnie Yip & Ming-Cheng Chang & Hui-Sheng Lin & Shyh-Dye Lee & Ya-Ling Chiu & Yu-Hsuan Lin, 2007. "The effects of Taiwan's National Health Insurance on access and health status of the elderly," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 223-242.
    17. Liu, Yuanli & Hsiao, William C. L. & Li, Qing & Liu, Xingzhu & Ren, Minghui, 1995. "Transformation of China's rural health care financing," Social Science & Medicine, Elsevier, vol. 41(8), pages 1085-1093, October.
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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. Chen, Yuyu & Jin, Ginger Zhe, 2012. "Does health insurance coverage lead to better health and educational outcomes? Evidence from rural China," Journal of Health Economics, Elsevier, vol. 31(1), pages 1-14.
    3. Liu, Hong & Sun, Qi & Zhao, Zhong, 2014. "Social learning and health insurance enrollment: Evidence from China's New Cooperative Medical Scheme," Journal of Economic Behavior & Organization, Elsevier, vol. 97(C), pages 84-102.
    4. Jacopo Bonan & Philippe LeMay-Boucher & Michel Tenikue, 2014. "Households' Willingness to Pay for Health Microinsurance and its Impact on Actual Take-up: Results from a Field Experiment in Senegal," Journal of Development Studies, Taylor & Francis Journals, vol. 50(10), pages 1445-1462, November.
    5. Mebratie, A.D. & Sparrow, R.A. & Alemu, G. & Bedi, A.S., 2013. "Community-Based Health Insurance Schemes," ISS Working Papers - General Series 568, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
    6. Acharya, Arnab & Vellakkal, Sukumar & Taylor Fiona & Masset Edoardo & Satija, Ambika & Burke, Margaret & Ebrahim, Shah, 2013. "The impact of health insurance schemes for the informal sector in low- and middle-income countries : a systematic review," Policy Research Working Paper Series 6324, The World Bank.
    7. Lisa Bagnoli, 2017. "Does National Health Insurance Improve Children's Health ?National and Regional Evidence from Ghana," Working Papers ECARES ECARES 2017-03, ULB -- Universite Libre de Bruxelles.
    8. Feng Huang & Li Gan, 2015. "Impact of China's Urban Employee Basic Medical Insurance on Health Care Expenditure and Health Outcomes," NBER Working Papers 20873, National Bureau of Economic Research, Inc.
    9. Ali, Shehzad & Cookson, Richard & Dusheiko, Mark, 2017. "Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure," Social Science & Medicine, Elsevier, vol. 177(C), pages 127-140.
    10. Adam Wagstaff & Winnie Yip & Magnus Lindelow & William C. Hsiao, 2009. "China's health system and its reform: a review of recent studies," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 7-23, July.
    11. S. Savitha & K. Kiran, 2015. "Effectiveness of micro health insurance on financial protection: Evidence from India," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 53-71, March.
    12. Rebecca L. Thornton & Laurel E. Hatt & Erica M. Field & Mursaleena Islam & Freddy Solís Diaz & Martha Azucena González, 2010. "Social security health insurance for the informal sector in Nicaragua: a randomized evaluation," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 181-206, September.
    13. Yingru Li & Yehua Dennis Wei, 2014. "Multidimensional Inequalities in Health Care Distribution in Provincial China: A Case Study of Henan Province," Tijdschrift voor Economische en Sociale Geografie, Royal Dutch Geographical Society KNAG, vol. 105(1), pages 91-106, February.
    14. Xiaoyan Lei & Wanchuan Lin, 2009. "The New Cooperative Medical Scheme in rural China: does more coverage mean more service and better health?," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 25-46, July.
    15. Mebratie, A.D. & Sparrow, R.A. & Debebe, Z.Y. & Abebaw Ejigie, D. & Alemu, G. & Bedi, A.S., 2014. "The impact of Ethiopia’s pilot community based health insurance scheme on healthcare utilization and cost of care," ISS Working Papers - General Series 77021, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
    16. 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.
    17. 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.
    18. repec:bla:glopol:v:8:y:2017:i::p:110-116 is not listed on IDEAS

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