Extending Health Insurance to the Rural Population : An Impact Evaluation of China's New Cooperative Medical Scheme
In 2003, after over 20 years of minimal
health insurance coverage in rural areas, China launched a
heavily subsidized voluntary health insurance program for
rural residents. The authors use program and household
survey data, as well as health facility census data, to
analyze factors affecting enrollment into the program and to
estimate its impact on households and health facilities.
They obtain estimates by combining
differences-in-differences with matching methods. The
authors find some evidence of lower enrollment rates among
poor households, holding other factors constant, and higher
enrollment rates among households with chronically sick
members. The household and facility data point to the scheme
significantly increasing both outpatient and inpatient
utilization (by 20-30 percent), but they find no impact on
utilization in the poorest decile. For the sample as a
whole, the authors find no statistically significant effects
on average out-of-pocket spending, but they do find
some-albeit weak-evidence of increased catastrophic health
spending. For the poorest decile, by contrast, they find
that the scheme increased average out-of-pocket spending but
reduced the incidence of catastrophic health spending. They
find evidence that the program has increased ownership of
expensive equipment among central township health centers
but had no impact on cost per case.
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Bibliographic Details
| Main Authors: |
Jun, Gao,
Wagstaff, Adam,
Ling, Xu,
Lindelow, Magnus,
Juncheng, Qian |
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| Language: | English |
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| Published: |
World Bank, Washington, DC
2007-03
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| Subjects: | ADVERSE SELECTION,
AGE STRUCTURE,
AGRICULTURE,
CITIES,
COST CONTROL,
COST-SHARING ARRANGEMENTS,
DELIVERY SYSTEM,
DEVELOPMENT RESEARCH GROUP,
DISTRICTS,
ECONOMIC DEVELOPMENT,
ECONOMIES OF SCALE,
EDUCATIONAL ATTAINMENT,
EXPENDITURES,
FAMILIES,
FEE-FOR-SERVICE,
GENDER,
HEALTH CARE,
HEALTH CARE PROVIDERS,
HEALTH EXPENDITURES,
HEALTH INSURANCE,
HEALTH INSURANCE PROGRAM,
HEALTH INSURANCE SCHEME,
HEALTH SERVICES,
HEALTH SPENDING,
HEALTH STATUS,
HEALTH SYSTEM,
HOSPITALS,
HOUSEHOLD EXPENDITURE,
HOUSEHOLD INCOME,
HOUSEHOLD LEVEL,
HOUSEHOLD SIZE,
HOUSEHOLD SURVEY,
HOUSEHOLDS,
INCOME DISTRIBUTION,
INCOME GROUPS,
INFORMAL SECTOR,
INFORMAL SECTOR WORKERS,
INSURERS,
LOCAL GOVERNMENTS,
MEDICAL SERVICES,
MEDICAL SYSTEM,
MORAL HAZARD,
MORTALITY,
NATIONAL HEALTH,
NATIONAL HEALTH SERVICE,
OCCUPANCY,
OUTPATIENT CARE,
POCKET PAYMENTS,
POLICY RESEARCH,
POOR HOUSEHOLDS,
POSITIVE SPILLOVERS,
PUBLIC HEALTH,
PUBLIC HEALTH INSURANCE,
QUALITY CONTROL,
RURAL AREAS,
RURAL HOUSEHOLDS,
RURAL POPULATION,
SAFETY,
SOCIAL HEALTH INSURANCE,
STANDARD ERRORS,
VILLAGES,
WORKERS, |
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| Online Access: | http://documents.worldbank.org/curated/en/2007/03/7410304/extending-health-insurance-rural-population-impact-evaluation-chinas-new-cooperative-medical-scheme
https://hdl.handle.net/10986/7202
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