Chen, M and Palmer, AJ and Si, L, Improving equity in health care financing in China during the progression towards Universal Health Coverage, BMC Health Services Research, 17, (1) Article 852. ISSN 1472-6963 (2017) [Refereed Article]
Copyright 2017 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/
Methods: We used progressivity analysis and dominance test to evaluate the financing channels of general taxation, pubic health insurance, and out-of-pocket (OOP) payments. In 2012 a survey of 8854 individuals in 3008 households recorded the socioeconomic and demographic status, and health care payments of those households.
Results: The overall Kakwani index (KI) of China's health care financing system is 0.0444. For general tax KI was -0.0241 (95% confidence interval (CI): -0.0315 to -0.0166). The indices for public health schemes (Urban Employee Basic Medical Insurance, Urban Resident's Basic Medical Insurance, New Rural Cooperative Medical Scheme) were respectively 0.1301 (95% CI: 0.1008 to 0.1594), -0.1737 (95% CI: -0.2166 to -0.1308), and -0.5598 (95% CI: -0.5830 to -0.5365); and for OOP payments KI was 0.0896 (95%CI: 0.0345 to 0.1447). OOP payments are still the dominant part of China's health care finance system.
Conclusion: China's health care financing system is not really equitable. Reducing the proportion of indirect taxes would considerably improve health care financing equity. The flat-rate contribution mechanism is not recommended for use in public health insurance schemes, and more attention should be given to optimizing benefit packages during China's progression towards UHC.
|Item Type:||Refereed Article|
|Keywords:||financing equity, progressivity, kakwani index, universal health coverage|
|Research Group:||Applied Economics|
|Research Field:||Health Economics|
|Objective Group:||Health and Support Services|
|Objective Field:||Health Policy Economic Outcomes|
|UTAS Author:||Palmer, AJ (Professor Andrew Palmer)|
|UTAS Author:||Si, L (Mr Lei Si)|
|Web of Science® Times Cited:||1|
|Deposited By:||Menzies Institute for Medical Research|
|Downloads:||63 View Download Statistics|
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