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Who benefited from the New Rural Cooperative Medical System in China? A case study on Anhui Province

Citation

Wang, L and Wang, A and FitzGerald, G and Si, L and Jiang, Q and Ye, D, Who benefited from the New Rural Cooperative Medical System in China? A case study on Anhui Province, BMC Health Services Research, 16, (1) Article 195. ISSN 1472-6963 (2016) [Refereed Article]


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Copyright 2016 Wang et al. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/

DOI: doi:10.1186/s12913-016-1441-3

Abstract

BACKGROUND: The goal of the New Rural Cooperative Medical System (NCMS) is to decrease the financial burden and improve the health of rural areas. The purpose of the present study is to determine how government subsidies vary between poorer and wealthier groups, especially in low-income regions in rural China.

METHODS: The distribution, amount, and equity of government subsidies delivered via NCMS to rural residents at different economic levels were assessed using benefit-incidence analysis, concentration index, Kakwani index, Gini index, Lorenz curve, and concentration curve. Household and health institution surveys were conducted in 2010, covering 9701 residents. Household socio-economic status, healthcare costs, out-of-pocket payments, and utilization information were collected in household interviews, and reimbursement policy was provided by institutional survey.

RESULTS: The government subsidy concentration index was -0.055 for outpatients and 0.505 for inpatients; and the outpatient and inpatient subsidy Kakwani indexes were -0.376 and 0.184, respectively. The poorest 20 % of populations received 3.4 % of the total subsidy output; while the wealthiest 20 % received 54.3 %. The results showed that the distribution of outpatient subsidies was equitable, but the hospital subsidies disproportionally benefited wealthier people.

CONCLUSIONS: Wealthier people benefited more than poorer people from the NCMS in terms of inpatient and total subsidies. For outpatients, the subsidies were unrelated to ability to pay. This contradicts the common belief that the NCMS does not exacerbate benefit inequity. Long-term policy is required to tackle this problem, specifically of redesign the NCMS reimbursement system.

Item Details

Item Type:Refereed Article
Keywords:Benefit incidence analysis, Concentration index, Kakwani index, Subsidy, NCMS, Health equity, health insurance, China
Research Division:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Public Health and Health Services not elsewhere classified
Objective Division:Health
Objective Group:Health and Support Services
Objective Field:Health Inequalities
Author:Si, L (Mr Lei Si)
ID Code:114330
Year Published:2016
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-02-13
Last Modified:2017-04-10
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