How does the New Cooperative Medical Scheme influence health service utilization? A study in two provinces in rural China.
Background: Many countries are developing health financing mechanisms to pursue the goal of universal coverage. In China, a rural health insurance system entitled New Cooperative Medical Scheme (NCMS) is being developed since 2003. Although there is concern about whether the NCMS will influence the...
| Publicado en: | BMC Health Services Research Vol. 10; pp. 116 - 117 |
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| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
BioMed Central
2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104569199&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104569199 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14726963 1CHS jtl: BMC Health Services Research issn: 14726963 maglogo: N pubinfo: dt: 2010 vid: 10 pid: 24147 pub: BioMed Central artinfo: ui: 104569199 NLM20459726 2010663922 10.1186/1472-6963-10-116 NLM20459726 PMC2907764 104569199 ppf: 116 ppct: 1 formats: tig: atl: How does the New Cooperative Medical Scheme influence health service utilization? A study in two provinces in rural China. aug: au: Yu B Meng Q Collins C Tolhurst R Tang S Yan F Bogg L Liu X Yu, Baorong Meng, Qingyue Collins, Charles Tolhurst, Rachel Tang, Shenglan Yan, Fei Bogg, Lennart Liu, Xiaoyun affil: Centre for Health Management and Policy, Shandong University, 44 Wenhua Xi Road, Jinan, 250012, Shandong, China sug: subj: Insurance, Health Utilization Rural Health Services Utilization China Cross Sectional Studies Health Care Costs Financing, Government Economics Human Logistic Regression Residence Characteristics Rural Health Services Economics Organizations ab: Background: Many countries are developing health financing mechanisms to pursue the goal of universal coverage. In China, a rural health insurance system entitled New Cooperative Medical Scheme (NCMS) is being developed since 2003. Although there is concern about whether the NCMS will influence the serious situation of inequity in health service utilization in rural China, there is only limited evidence available. This paper aims to assess the utilisation of outpatient and inpatient services among different income groups and provinces under NCMS in rural China.Methods: Using multistage sampling processes, a cross-sectional household survey including 6,147 rural households and 22,636 individuals, was conducted in six counties in Shandong and Ningxia Provinces, China. Chi-square test, Poisson regression and log-linear regression were applied to analyze the association between NCMS and the utilization of outpatient and inpatient services and the length of stay for inpatients. Qualitative methods including individual interview and focus group discussion were applied to explain and complement the findings from the household survey.Results: NCMS coverage was 95.9% in Shandong and 88.0% in Ningxia in 2006. NCMS membership had no significant association with outpatient service utilization regardless of income level and location.Inpatient service utilization has increased for the high income group under NCMS, but for the middle and low income, the change was not significant. Compared with non-members, NCMS members from Ningxia used inpatient services more frequently, while members from Shandong had a longer stay in hospital.High medical expenditure, low reimbursement rate and difference in NCMS policy design between regions were identified as the main reasons for the differences in health service utilization.Conclusions: Outpatient service utilization has not significantly changed under NCMS. Although utilization of inpatient service in general has increased under NCMS, people with high income tend to benefit more than the low income group. While providing financial protection against catastrophic medical expenditure is the principal focus of NCMS, this study recommends that outpatient services should be incorporated in future NCMS policy development. NCMS policy should also be more equity oriented to achieve its policy goal. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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