Document Detail


Catastrophic medical payment and financial protection in rural China: evidence from the New Cooperative Medical Scheme in Shandong Province.
MedLine Citation:
PMID:  18283715     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To measure the impact of China's New Cooperative Medical Scheme (NCMS) on catastrophic medical payments of rural households in Linyi County, Shandong Province. METHOD: In 2005, from a stratified cluster sample of 3101 rural households, we identified 375 households that might be at risk of catastrophic payments by searching through NCMS claims and interviewing key informants. We interviewed these 375 households and confirmed that 231 had had catastrophic payments (> or = 40% of the households' capacity to pay; CTP) during 2004. A validity test of our screening method found another eight cases among immediate neighbours of these 375 households; by extrapolation, we obtained an adjusted total of 289 catastrophic households in the sample of 3101. We measured the impact of the NCMS on hardship alleviation by counterfactual analysis, comparing catastrophic payments before and after NCMS reimbursements. RESULT: The effect was twofold. Before NCMS intervention 8.98% of Linyi population had had catastrophic out-of-pocket payments compared with 8.25% after reimbursements. Catastrophic severity for households remaining in catastrophe after reimbursement dropped by 18.7% to an average of 6.34 times the household's CTP. CONCLUSION: Out-of-pocket medical payments remain a burden for rural households. Financial protection from the NCMS, with an average reimbursement of 17.8%, was modest and should be restructured to provide better benefits that are targeted to those in most need.
Authors:
Xiaoyun Sun; Sukhan Jackson; Gordon Carmichael; Adrian C Sleigh
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Health economics     Volume:  18     ISSN:  1057-9230     ISO Abbreviation:  Health Econ     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-16     Completed Date:  2009-03-03     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  9306780     Medline TA:  Health Econ     Country:  England    
Other Details:
Languages:  eng     Pagination:  103-19     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2008 John Wiley & Sons, Ltd.
Affiliation:
Health Department of Shandong Province, Jinan, China. sxysdcn@yahoo.com.cn
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MeSH Terms
Descriptor/Qualifier:
Catastrophic Illness / economics*
China
Family Characteristics
Female
Financing, Organized / economics*
Health Expenditures
Humans
Insurance, Health / economics*
Interviews as Topic
Male
Models, Econometric
Pilot Projects
Program Evaluation
Rural Health / statistics & numerical data

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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