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An Economic Insight into Health Care in Six Chinese Counties: Equity in Crisis
Mälardalen University, School of Health, Care and Social Welfare. Karolinska institutet. (Global health Department of Public Health Sciences)ORCID iD: 0000-0003-0368-050X
Zhejiang University, School of Public Health, China.
2010 (English)In: International Health & Aid Policies: the Need for Alternatives / [ed] Unger, Jean-Pierre; De Paepe, Pierre; Sen, Kasturi; Soors, Werner, Cambridge University Press, 2010, 123-137 p.Chapter in book (Refereed)
Abstract [en]

Objectives:

To assess inequity in health care financing and utilisation, its associated socio-economic variables and consequences, with focus on the impact of alternative health financing systems.

 

Methods

Econometric and multivariate analysis of cross-sectional and retrospective household survey data from six counties in three provinces in Central China.

 

Findings:

The old Cooperative Medical System (CMS) was associated with a five times less risk of financial difficulties, half the risk of care-induced debt (non-significant, 95%CI 0.2-1.1) and not one CMS participant having to forego care due to cost. CMS was associated with better health, three times less risk of illness with duration of at least one month. Other health insurance systems were associated with higher risk of illness, higher outpatient expenditure without evidence of reducing barriers to care. The elderly (60 years +) had a more than five times increased risk of illness for at least one month, (OR = 5.2, 95%CI = 3.2-8.3). The illness concentration index confirmed that the poor suffer from a higher prevalence of morbidity. The Le Grand index confirmed strong bias in utilisation favouring the rich. The Kakwani index confirmed an extremely high degree of regressivity in the financing of health services, (-0.73) for outpatient and (-0.94) for inpatient services. The New Cooperative Medical System (NCMS) differs from the old CMS in critical aspects.

Place, publisher, year, edition, pages
Cambridge University Press, 2010. 123-137 p.
Keyword [en]
health insurance, health financing, equity, access, utilisation, China
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Care Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-7970DOI: 10.1017/CBO9780511902512ISBN: 978-0-521-17426-8 (print)OAI: oai:DiVA.org:mdh-7970DiVA: diva2:292985
Projects
SAREC
Funder
Sida - Swedish International Development Cooperation Agency
Available from: 2011-02-03 Created: 2010-02-10 Last updated: 2015-08-17Bibliographically approved

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CiteExportLink to record
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Citation style
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