scholarly journals Barriers of effective health insurance coverage for rural-to-urban migrant workers in China: a systematic review and policy gap analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shanquan Chen ◽  
Yingyao Chen ◽  
Zhanchun Feng ◽  
Xi Chen ◽  
Zheng Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Insurance ◽  
Migrant Workers ◽  
Gap Analysis ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Urban Migrant

scholarly journals Barriers of effective health insurance coverage for rural-to-urban migrant workers in China: A systematic review and policy gap analysis

2019 ◽  
Author(s):  
Shanquan Chen ◽  
Yingyao Chen ◽  
Zhanchun Feng ◽  
Xi Chen ◽  
Zheng Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Insurance ◽  
Migrant Workers ◽  
Gap Analysis ◽  
Central Government ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Cochrane Library ◽  
Job Stability ◽  
Urban Migrant

Abstract Objective: To review China’s healthcare policies and their applications to rural-to-urban migrant workers (RUMWs) in China, to identify problems faced by RUMWs and the policy gaps that need to be addressed in future, and to facilitate better implementation of the UHC on RUMWs. Methods: A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The searched databases included PubMed, Embase, Medline, Web of Science, PsycINFO, Maternity and Infant Care Database MIDIRS, the Cochrane Library, WHO Library Database (WHOLIS), WHO Global Health Library, World Bank eLibrary, OpenGrey, CNKI, and Wanfang. In total 71 articles were reviewed. Findings: (1) Chinese RUMWs have a high work mobility and low job stability; (2) Barriers faced by RUMWs to have effective health insurance coverage are mainly due to the reluctancy of employers to provide insurance for all employees and a disadvantaged position held by RUMWs when negotiating with their employers; (3) Fissures among existing health insurance schemes leaves no room for RUMWs to meet their primary needs; and (4) Recent efforts in improving the portability and transferability of insurance across borders and schemes are not enough to solve the barriers. Conclusion: It is argued that the Chinese central government must deal with the fragmentation of healthcare system in China and promote the effective coverage by: (1) playing a more active role in coordinating different healthcare and social welfare schemes across the country, (2) increasing the health insurance portability, (3) making the healthcare policies more compatible with RUMW’s characteristics to meet their primary health needs, (4) strengthening supervision over employers, and (5) providing more vocational trainings and other supports to increase RUMW’s job stability.

scholarly journals Barriers of effective health insurance coverage for rural-to-urban migrant workers in China: A systematic review and policy gap analysis

2020 ◽  
Author(s):  
Shanquan Chen(Former Corresponding Author) ◽  
Yingyao Chen ◽  
Zhanchun Feng ◽  
Xi Chen ◽  
Zheng Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Insurance ◽  
Migrant Workers ◽  
Gap Analysis ◽  
Central Government ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Cochrane Library ◽  
Job Stability ◽  
Urban Migrant

Abstract Background: More than 90% of the Chinese population was covered by its three basic social health insurances.However, the Chinese rural-to-urban migrant workers (RUMWs), accounting for about one-fifth of China’s total population, seem to be put on a disadvantaged position under the current health insurance schemes. The purpose of this study is to identify the current barriers and to provide policy suggestions to the ineffective health insurance coverage of RUMWs in China. Methods: A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The searched databases included PubMed, Embase, Medline, Web of Science, PsycINFO, Maternity and Infant Care Database MIDIRS, the Cochrane Library, WHO Library Database (WHOLIS), WHO Global Health Library, World Bank eLibrary, OpenGrey, CNKI, and Wanfang. In total, 70 articles were reviewed. Results: (1) Chinese RUMWs have high work mobility and low job stability; (2) Barriers faced by RUMWs in obtaining effective health insurance coverage are primarily due to the reluctance of employers to provide insurance for all employees and the disadvantaged position held by RUMWs when negotiating with their employers; (3) Fissures among existing health insurance schemes leaves no room for RUMWs to meet their primary needs; and (4) Recent efforts in improving the portability and transferability of insurance across borders and schemes are not enough to solve the barriers. Conclusion: It is argued that the Chinese central government must deal with the fragmentation of healthcare system in China and promote effective coverage by: (1) playing a more active role in coordinating different healthcare and social welfare schemes across the country, (2) increasing the health insurance portability, (3) making the healthcare policies more compatible with RUMW’s characteristics to meet their primary health needs, (4) strengthening supervision of employers, and (5) providing more vocational training and other support to increase RUMW’s job stability.

scholarly journals Barriers of effective health insurance coverage for rural-to-urban migrant workers in China: A systematic review and policy gap analysis

2020 ◽  
Author(s):  
Shanquan Chen ◽  
Yingyao Chen ◽  
Zhanchun Feng ◽  
Xi Chen ◽  
Zheng Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Insurance ◽  
Migrant Workers ◽  
Gap Analysis ◽  
Central Government ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Cochrane Library ◽  
Job Stability ◽  
Urban Migrant

Abstract Background: More than 90% of the Chinese population was covered by its three basic social health insurances. However, the Chinese rural-to-urban migrant workers (RUMWs), accounting for about one-fifth of China’s total population, seem to be put on a disadvantaged position under the current health insurance schemes. The purpose of this study is to identify the current barriers and to provide policy suggestions to the ineffective health insurance coverage of RUMWs in China. Methods: A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The searched databases included PubMed, Embase, Medline, Web of Science, PsycINFO, Maternity and Infant Care Database MIDIRS, the Cochrane Library, WHO Library Database (WHOLIS), WHO Global Health Library, World Bank eLibrary, OpenGrey, CNKI, and Wanfang. In total, 70 articles were reviewed. Results: (1) Chinese RUMWs have high work mobility and low job stability; (2) Barriers faced by RUMWs in obtaining effective health insurance coverage are primarily due to the reluctance of employers to provide insurance for all employees and the disadvantaged position held by RUMWs when negotiating with their employers; (3) Fissures among existing health insurance schemes leaves no room for RUMWs to meet their primary needs; and (4) Recent efforts in improving the portability and transferability of insurance across borders and schemes are not enough to solve the barriers. Conclusion: It is argued that the Chinese central government must deal with the fragmentation of healthcare system in China and promote effective coverage by: (1) playing a more active role in coordinating different healthcare and social welfare schemes across the country, (2) increasing the health insurance portability, (3) making the healthcare policies more compatible with RUMW’s characteristics to meet their primary health needs, (4) strengthening supervision of employers, and (5) providing more vocational training and other support to increase RUMW’s job stability.

Health Insurance Coverage of Migrant Workers in China

2021 ◽  
pp. 1-11
Author(s):  
Yu Chen ◽  
Marie Parker ◽  
Xiaodong Zheng ◽  
Xiangming Fang
Keyword(s):  
Health Insurance ◽  
Migrant Workers ◽  
Insurance Coverage ◽  
Health Insurance Coverage

scholarly journals Expanding health insurance coverage in vulnerable groups: a systematic review of options

2010 ◽  
Vol 26 (2) ◽  
pp. 93-104 ◽  
Author(s):  
Q. Meng ◽  
B. Yuan ◽  
L. Jia ◽  
J. Wang ◽  
B. Yu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Insurance ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Vulnerable Groups

scholarly journals Hukou and Health Insurance Coverage for Migrant Workers

2016 ◽  
Vol 45 (2) ◽  
pp. 53-82 ◽  
Author(s):  
Armin Müller
Keyword(s):  
Health Insurance ◽  
Migrant Workers ◽  
Social Protection ◽  
Insurance Coverage ◽  
Mainland China ◽  
Health Insurance Coverage ◽  
Health Insurance System ◽  
Coverage Problem ◽  
Policy Initiatives ◽  
Migration Systems

Most migrant workers in mainland China are officially covered by the New Rural Cooperative Medical System (NRCMS), a rural health insurance system that operates in their home communities. The NRCMS and the system of household registration ([Formula: see text], hukou) are tightly linked and systemically interdependent institutions. Migrant workers have difficulties benefitting from this social protection because it remains spatially separated from them. Only a minority have access to urban health insurance systems. This paper sheds light on the institutional origins of the coverage problem of migrant workers and examines crucial policy initiatives that attempt to solve it. In the context of the ongoing hukou reforms, these policies aim to partially dissolve the systemic interdependence of hukou and health insurance. While the policies provide feasible, yet conflict-prone, solutions in short-distance and concentrated bilateral migration systems, covering migrants who cross provincial boundaries remains a challenge.

scholarly journals Measuring inequity in using routinely collected data in an emergency setting: a systematic review

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
K Morisod ◽  
X Luta ◽  
J Marti ◽  
T Brauchli ◽  
J Spycher ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Insurance ◽  
Access To Care ◽  
Health Equity ◽  
Hospital Care ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
Health Inequity ◽  
Race Ethnicity ◽  
And Gender

Abstract Background The international literature has highlighted many potential challenges in terms of inequitable access to care. In the last few years, health equity is becoming an increasingly important issue for policymakers, particularly in developed countries. The aim of this systematic review was to find how equity is measured and to identify some of its determinants. Methods We conducted a systematic review on all major databases (Medline Ovid SP, PubMed, Embase and Web of Science), following the PRISMA guidelines. We included published observational studies that reported on health equity and using administrative data, with a focus on emergency and unplanned hospital care. Study selection and data extraction were conducted independently and compared by two reviewers. Results In total, 223 records were screened and 39 articles met the inclusion criteria. Studies come from the United States (US) (23), United Kingdom (6), Canada (4), Australia (2) and some European countries (4). To measure health inequity, most of the studies used at least one of these 4 indicators: hospitalisations for chronic ambulatory care sensitive conditions (or preventable hospitalisations), emergency hospitalisation rate, readmissions or mortality. The most relevant health equity determinants concerned race/ethnicity (19), poverty (17), health insurance coverage (17) and gender (16). Race/ethnicity and gender are important determinants of inequities. Concerning poverty, despite the use of heterogeneous indicators, most of studies showed a socio-economic gradient of access to care. Health insurance coverage was often used but with conflicting results. Conclusions The use of indicators linking primary, emergency and hospital care seems to be particularly relevant to measure health inequity. Race/ethinicity, gender and socio-economic status are clear determinants of inequitable access to care. More studies are needed to explain and analyse the determinants of health equity. Key messages Health equity remains a major issue even for high-income countries health care system. Quantitative data about health equity still are needed to support policymaker’s recommendation.

scholarly journals Health Insurance Coverage Disruptions and Cancer Care and Outcomes: Systematic Review of Published Research

2020 ◽  
Vol 112 (7) ◽  
pp. 671-687 ◽  
Author(s):  
K Robin Yabroff ◽  
Katherine Reeder-Hayes ◽  
Jingxuan Zhao ◽  
Michael T Halpern ◽  
Ana Maria Lopez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Insurance ◽  
Low Income ◽  
Cancer Care ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Stage At Diagnosis ◽  
Data Infrastructure ◽  
Study Characteristics

Abstract Background Lack of health insurance coverage is associated with poor access and receipt of cancer care and survival in the United States. Disruptions in coverage are common among low-income populations, but little is known about associations of disruptions with cancer care, including prevention, screening, and treatment, as well as outcomes of stage at diagnosis and survival. Methods We conducted a systematic review of studies of health insurance coverage disruptions and cancer care and outcomes published between 1980 and 2019. We used the PubMed, EMBASE, Scopus, and CINAHL databases and identified 29 observational studies. Study characteristics and key findings were abstracted and synthesized qualitatively. Results Studies evaluated associations between coverage disruptions and prevention or screening (31.0%), treatment (13.8%), end-of-life care (10.3%), stage at diagnosis (44.8%), and survival (20.7%). Coverage disruptions ranged from 4.3% to 32.8% of patients age-eligible for breast, cervical, or colorectal cancer screening. Between 22.1% and 59.5% of patients with Medicaid gained coverage only at or after cancer diagnosis. Coverage disruptions were consistently statistically significantly associated with lower receipt of prevention, screening, and treatment. Among patients with cancer, those with Medicaid disruptions were statistically significantly more likely to have advanced stage (odds ratios = 1.2-3.8) and worse survival (hazard ratios = 1.28-2.43) than patients without disruptions. Conclusions Health insurance coverage disruptions are common and adversely associated with receipt of cancer care and survival. Improved data infrastructure and quasi-experimental study designs will be important for evaluating the associations of federal and state policies on coverage disruptions and care and outcomes.

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