An evaluation of China's new rural cooperative medical system: achievements and inadequacies from policy goals.
Background: Although much public scrutiny and academic attention has focused on the evaluations of system implementation since the beginning of New Rural Cooperative Medical System (NRCMS) in China, few studies have systematically evaluated the achievements of the stated policy goals. The purpose of...
| Publicado en: | BMC Public Health Vol. 15; no. 1; pp. 1 - 10 |
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| Autores principales: | , , , , , , , , , , , , , , , |
| Formato: | equations & formulas research tables/charts Journal Article |
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BioMed Central
10/23/2015
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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=110579377&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 110579377 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14712458 1CIK jtl: BMC Public Health issn: 14712458 maglogo: N pubinfo: dt: 10/23/2015 vid: 15 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 110579377 110579377 NLM26494015 110579377 10.1186/s12889-015-2410-1 NLM26494015 PMC4619227 110579377 ppf: 1 ppct: 9 formats: tig: atl: An evaluation of China's new rural cooperative medical system: achievements and inadequacies from policy goals. aug: au: Chengyue Li Yilin Hou Mei Sun Jun Lu Ying Wang Xiaohong Li Fengshui Chang Mo Hao Li, Chengyue Hou, Yilin Sun, Mei Lu, Jun Wang, Ying Li, Xiaohong Chang, Fengshui Hao, Mo affil: Research Institute of Health Development Strategies, Fudan University, 130 Dong An Road, Shanghai 200032, China sug: subj: Health Care Delivery Administration Health Policy Economics Rural Population Rural Health Services Administration National Health Programs Administration Financial Support Rural Health Services Economics China Achievement Financing, Organized Statistics and Numerical Data Adult Health Care Delivery Goals and Objectives Female Cross Sectional Studies Male Human Adult: 19-44 years Female Male ab: Background: Although much public scrutiny and academic attention has focused on the evaluations of system implementation since the beginning of New Rural Cooperative Medical System (NRCMS) in China, few studies have systematically evaluated the achievements of the stated policy goals. The purpose of this study is to examine to what extent the policy goals of NRCMS have been achieved.Methods: Using multistage sampling processes, two rounds of cross-sectional household surveys including 9787 and 7921 rural households were conducted in Eastern China in year 2000 and year 2008, respectively. A pre- and post-implementation comparison was used to evaluate the achievement of policy goals in three measures: impoverishment from major health hazards, household financial risk from medical expenses, and rural income inequity. Intention surveys were also applied to find out potential obstacles in the implementation of NRCMS.Results: The rate of re-impoverishment from health hazard was reduced from 2.69 % ex ante to 2.12 % ex post, a decrease of 21.13 %. The severity of impoverishment fell from a previous 4.66 % to 3.02 %, a decline of 35.18 %. Economic risk of medical treatment population relative to the whole population fell from 2.62 ex ante to 2.03 ex post, a 22.52 % reduction. As indication of effect on improving income equity, the Gini coefficient fell from 0.4629 to 0.4541. The effects of NRCMS were significantly better than those of RCMS. Despite the preliminary achievements, our intention survey of key respondents identified that technical difficulties in actuarial funding and more sustainable reimbursement schedules has become the most challenging barriers in achieving the goals of NRCMS, while raising the insurance premium on NRCMS was no longer as big a barrier.Conclusions: With NRCMS, China has established a medical security system to reduce the financial burden of healthcare on rural residents. NRCMS has achieved some positive though limited effects; but technical difficulties in the implementation of NRCMS have become barriers to achieve the pre-set policy goals. Efforts should be made to improve the capacity building in the design of the reimbursement schemes for the implementers of NRCMS, such as identifying medical impoverishment, calculating actuarial funding levels for the risk pooling. pubtype: Academic Journal doctype: equations & formulas research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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