Catastrophic Payment and Health Protection in Rural China - Impact of New Cooperative Medical Scheme in Shandong Province

Sun, Xiaoyun, Jackson, Sukhan, Carmichael, Gordon and Sleigh, Adrian C. (2007) Catastrophic Payment and Health Protection in Rural China - Impact of New Cooperative Medical Scheme in Shandong Province. Discussion Paper Discussion Paper No. 344, School of Economics.


Author Sun, Xiaoyun
Jackson, Sukhan
Carmichael, Gordon
Sleigh, Adrian C.
Title Catastrophic Payment and Health Protection in Rural China - Impact of New Cooperative Medical Scheme in Shandong Province
School, Department or Centre School of Economics
Report Number Discussion Paper No. 344
Series Discussion Paper
Publication date 2007
Language eng
Subject 140208 Health Economics
Formatted Abstract/Summary
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 3,101 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 239 had had catastrophic payments (≥ 40% of the household’s capacity to pay) during 2004. A validity test of our screening method found another 8 cases among immediate neighbours of these 375 households; by extrapolation, we obtained an adjusted total of 289 catastrophic households in the sample of 3,101. 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 9.32% of the sample households had had catastrophic out-of-pocket payments compared to 8.55% after reimbursements. Catastrophic severity dropped by 21.3% for households remaining in catastrophe after reimbursement, to an average of 6.34 times the household’s capacity to pay.

Conclusion: Out-of-pocket medical payments remain a burden for rural households. Financial protection from the NCMS was modest with an average reimbursement of 17.8% of total medical costs, and should be restructured to provide better benefits and to target those in most need.

Keyword China
medical costs
community financing
catastrophic illness
rural health
health insurance
health protection
Additional Notes ISSN 1445-5523

Document type: Department Technical Report
Collections: Excellence in Research Australia (ERA) - Collection
School of Economics Publications
 
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Created: Tue, 07 Apr 2009, 13:39:02 EST by Maryanne Watson on behalf of School of Economics