scholarly journals Impact of the New Cooperative Medical Scheme on the trend of catastrophic health expenditure in Chinese rural households: results from nationally representative surveys from 2003 to 2013

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019442 ◽  
Author(s):  
Biao Xie ◽  
Minghe Huo ◽  
Zhiqiang Wang ◽  
Yongjie Chen ◽  
Rong Fu ◽  
...  
Keyword(s):  
Low Income ◽  
Rural China ◽  
Rural Households ◽  
Catastrophic Health Expenditure ◽  
Incidence Rates ◽  
New Cooperative Medical Scheme ◽  
Middle Income ◽  
Cooperative Medical Scheme ◽  
Nationally Representative ◽  
Using Data

ObjectiveTo evaluate the trend of catastrophic health expenses (CHE) for inpatient care in relation to the commencement of the New Cooperative Medical Scheme (NCMS) in rural China from 2003 to 2013, and the roles of NCMS in protecting affected households from CHE.MethodsWe assessed the 10-year trend of the incidence and severity of CHE in rural households with hospitalised members using data from the Chinese National Health Services Survey. Generalised estimating equations were used to estimate the OR and 95% CI of the association between incidence rates of CHE (RCHE) and NCMS reimbursement.ResultsThe incidence and severity of CHE after NCMS reimbursement both decreased and their changes increased rapidly from 2003 to 2013. After adjustment of the covariates,RCHEbefore reimbursement was significantly higher than that after reimbursement, and the OR (95% CI) was 1.50 (1.24 to 1.81), 1.79 (1.69 to 1.90) and 2.94 (2.77 to 3.11) in 2003, 2008 and 2013, respectively.ConclusionThe incidence and severity of CHE both reduced after NCMS reimbursements in each year. Excluding some confounding factors,RCHEwas significantly associated with NCMS reimbursement. NCMS partly protected the rural households with hospitalised members from CHE. However, the inequalities between different income groups still existed.RCHEin rural households with hospitalised members was still rather high in 2003, 2008 and 2013 even though they were covered by NCMS. This study will provide suggestions for further reforms in China and guidance for other low-income/middle-income countries.

scholarly journals Are People Enrolled in NCMS and CURBMI Susceptible in Catastrophic Health Expenditure? Evidence From China

2020 ◽  
Vol 57 ◽  
pp. 004695802091928
Author(s):  
Xinpeng Xu ◽  
Hai Gu ◽  
Hua You ◽  
Lan Bai ◽  
Decheng Li ◽  
...  
Keyword(s):  
Low Income ◽  
Health Expenditure ◽  
Medical Insurance ◽  
Catastrophic Health Expenditure ◽  
New Cooperative Medical Scheme ◽  
Basic Medical Insurance ◽  
Medical Institutions ◽  
Significant Difference ◽  
Cooperative Medical Scheme ◽  
Basic Medical

This study investigated associations between different types of medical insurance and the incidence of catastrophic health expenditure among middle-aged and the aged in China. The data came from the China Health and Retirement Longitudinal Survey implemented in 2013, with 9782 individuals analyzed. Probit regression models and multiple linear regressions were employed to explore the relationship mentioned above and potential mechanisms behind it. It was found that compared with participants in Urban Resident Basic Medical Insurance, individuals participating in New Cooperative Medical Scheme and Coordinating Urban and Rural Basic Medical Insurance was less likely to undergo catastrophic health expenditure ( P < .001, P = .008), especially for low-income and middle-income group. Participants in New Cooperative Medical Scheme and Coordinating Urban and Rural Basic Medical Insurance were more likely to utilize inpatient medical service ( P < .001, P = .020) and choose low-level medical institutions for treatment ( P = .003, P = .006). And individuals participating in New Cooperative Medical Scheme had lower out-of-pocket expenditure ( P = .034). The study showed the significant difference in the incidence of catastrophic health expenditure among participants in different medical insurances. Efforts should be made to improve the service quality of grassroots medical institutions except for the increase of reimbursement ratio, so that rural residents can enjoy high-quality medical services.

scholarly journals Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data

2020 ◽  
Vol 5 (11) ◽  
pp. e003423
Author(s):  
Dongqing Wang ◽  
Molin Wang ◽  
Anne Marie Darling ◽  
Nandita Perumal ◽  
Enju Liu ◽  
...  
Keyword(s):  
Weight Gain ◽  
North Africa ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Gestational Weight ◽  
Latin America And Caribbean ◽  
Nationally Representative ◽  
Sub Saharan

IntroductionGestational weight gain (GWG) has important implications for maternal and child health and is an ideal modifiable factor for preconceptional and antenatal care. However, the average levels of GWG across all low-income and middle-income countries of the world have not been characterised using nationally representative data.MethodsGWG estimates across time were computed using data from the Demographic and Health Surveys Program. A hierarchical model was developed to estimate the mean total GWG in the year 2015 for all countries to facilitate cross-country comparison. Year and country-level covariates were used as predictors, and variable selection was guided by the model fit. The final model included year (restricted cubic splines), geographical super-region (as defined by the Global Burden of Disease Study), mean adult female body mass index, gross domestic product per capita and total fertility rate. Uncertainty ranges (URs) were generated using non-parametric bootstrapping and a multiple imputation approach. Estimates were also computed for each super-region and region.ResultsLatin America and Caribbean (11.80 kg (95% UR: 6.18, 17.41)) and Central Europe, Eastern Europe and Central Asia (11.19 kg (95% UR: 6.16, 16.21)) were the super-regions with the highest GWG estimates in 2015. Sub-Saharan Africa (6.64 kg (95% UR: 3.39, 9.88)) and North Africa and Middle East (6.80 kg (95% UR: 3.17, 10.43)) were the super-regions with the lowest estimates in 2015. With the exception of Latin America and Caribbean, all super-regions were below the minimum GWG recommendation for normal-weight women, with Sub-Saharan Africa and North Africa and Middle East estimated to meet less than 60% of the minimum recommendation.ConclusionThe levels of GWG are inadequate in most low-income and middle-income countries and regions. Longitudinal monitoring systems and population-based interventions are crucial to combat inadequate GWG in low-income and middle-income countries.

Inequities in the allocation of medical resources in China’s Township Health Centers

2016 ◽  
Vol 8 (4) ◽  
pp. 637-646 ◽  
Author(s):  
Yue Ma ◽  
Linxiu Zhang ◽  
Matthew Boswell
Keyword(s):  
Low Income ◽  
Rural Areas ◽  
Rural China ◽  
Health Centers ◽  
Content Type ◽  
Representative Study ◽  
Use Of Data ◽  
Fixed Assets ◽  
Nationally Representative ◽  
Academy Of Sciences

Purpose The purpose of this paper is to produce a high-quality measure of the nature of healthcare resources available in China’s Township Health Centers (THCs), paying particular attention to equity between high- and low-income areas. Design/methodology/approach This study makes use of data from a nearly nationally representative survey in rural China conducted by the Center for Chinese Agricultural Policy at the Chinese Academy of Sciences in 2011. The samples of towns were selected randomly from 25 counties located in five provinces from different regions of China. Data were collected through questionnaires and direct observation. Findings The THCs located in rich areas have higher levels of human resources than poor areas. THCs in rich areas also have more fixed assets than those in poor areas. In fact, even though the Chinese Ministry of Health mandates that all THCs have certain basic levels of medical equipment and facilities, many THCs in poor areas do not have them. The allocation of mandated equipment is unequal. Practical implications These findings suggest that China’s government should pay more attention to THCs located in poor areas, especially in light of new initiatives to improve health care in poor rural areas. Originality/value This is the first nationally representative study to employ rigorous empirics to investigate the extent of inequality in allocation of resources within THCs across China.

scholarly journals Nonlinear Dynamics in the Finance-Inequality Nexus in China-CHNS Data

2019 ◽  
Vol 11 (1) ◽  
pp. 191 ◽  
Author(s):  
Mohammad Masudur Rahman ◽  
Guan Fuquan ◽  
Laila Arjuman Ara
Keyword(s):  
Financial Development ◽  
Low Income ◽  
Income Group ◽  
High Income Group ◽  
Middle Income ◽  
Linear Effect ◽  
Quantile Regression Model ◽  
Income Groups ◽  
Using Data ◽  
The Impact

This paper empirically investigates the effects of financial development on incomes of Chinese residents particularly within various income groups using data from six provinces by applying the Quantile Regression model. The Greenwood and Jovanovich hypothesis that illustrates the inverted U shaped relationship between financial development and income inequality is tested. This empirical study demonstrates that financial development has a positive but non-linear effect on the annual income of individuals from various income groups at different quantiles. The effect is an inverted U or Kuznets effect indicating an increase at first and then a drop. As for the distribution of the impact on various income groups, the low-income group is under the most dominant influence followed by the high-income group with the middle-income groups receiving relatively smaller influence. Findings indicate that promoting balanced financial development would help to ease the income gap between Chinese residents.

scholarly journals Heterogeneous Impacts of Basic Social Health Insurance on Medical Expenditure: Evidence from China’s New Cooperative Medical Scheme

Healthcare ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 131 ◽  
Author(s):  
Fang ◽  
He ◽  
Rozelle ◽  
Shi ◽  
Sun ◽  
...  
Keyword(s):  
Low Income ◽  
Social Health Insurance ◽  
Good Health ◽  
Income Group ◽  
Medical Expenditure ◽  
High Income Group ◽  
New Cooperative Medical Scheme ◽  
Health Group ◽  
Cooperative Medical Scheme ◽  
Low Income Groups

This paper examines the effects of China’s New Cooperative Medical Scheme (NCMS) on medical expenditure. Utilizing the quasi-random rollout of the NCMS for a difference-in-difference analysis, we find that the NCMS increased medical expenditure by 12.3%. Most significantly, the good-health group witnessed a 22.1% rise in medical expenditure, and the high-income group saw a rise of 20.6%. The effects, however, were not significant among the poor-health or low-income groups. The findings are suggestive of the need for more help for the very poor and less healthy.

Are low-to-middle-income households experiencing food insecurity in Victoria, Australia? An examination of the Victorian Population Health Survey, 2006–2009

2017 ◽  
Vol 23 (3) ◽  
pp. 249 ◽  
Author(s):  
Sue Kleve ◽  
Zoe E. Davidson ◽  
Emma Gearon ◽  
Sue Booth ◽  
Claire Palermo
Keyword(s):  
Food Insecurity ◽  
Population Health ◽  
Low Income ◽  
Home Ownership ◽  
Cross Sectional ◽  
Middle Income ◽  
Income Levels ◽  
Factors Associated ◽  
Health And Wellbeing ◽  
Using Data

Food insecurity affects health and wellbeing. Little is known about the relationship between food insecurity across income levels. This study aims to investigate the prevalence and frequency of food insecurity in low-to-middle-income Victorian households over time and identify factors associated with food insecurity in these households. Prevalence and frequency of food insecurity was analysed across household income levels using data from the cross-sectional 2006–09 Victorian Population Health Surveys (VPHS). Respondents were categorised as food insecure, if in the last 12 months they had run out of food and were unable to afford to buy more. Multivariable logistic regression was used to describe factors associated with food insecurity in low-to-middle-income households (A$40000–$80000 in 2008). Between 4.9 and 5.5% for total survey populations and 3.9–4.8% in low-to-middle-income respondents were food insecure. Food insecurity was associated with limited help from friends, home ownership status, inability to raise money in an emergency and cost of some foods. Food insecurity exists in households beyond those on a very low income. Understanding the extent and implications of household food insecurity across all income groups in Australia will inform effective and appropriate public health responses.

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