The coverage of the NRCMS expanded to cover nearly all rural inhabitants in Jiangxi province by 2014 and was associated with a very small reduction in inequalities in admission to hospital. In order to increase equitable access to health care, additional financial protections for vulnerable populations are needed. Improving the relatively low level of medical services in township hospitals, and low rate of reimbursement and financial assistance with the NRCMS is recommended.

(1) Background: Air quality apt to deteriorate in decades in China, people are seeking improvement measures. To assess the willingness to pay (WTP) for improved air quality among manufacturing workers and associated factors influencing their WTP. (2) Methods: A cross-sectional questionnaire survey was conducted in combination with contingent valuation in Nanchang between September and October of 2015. A face-to-face interview was conducted to obtain basic demographic information from manufacturing workers and to understand their WTP for air quality improvement. (3) Results: A total of 600 effective questionnaires were collected in this study and showed that more than half of the respondents (53%) expressed their WTP for improved air quality. Multivariable logistic regression analysis revealed that the main factors associated with manufacturing workers' WTP were their residence areas, education level, annual household income and travel experience. (4) Conclusions: These findings have provided (a) important information of the concern and desire for air pollution control through their WTP from manufacturing workers, (b) baseline information for the policy-maker and local government for their development of more effective policy in air pollution prevention and control and (c) the need for more study for WTP among different population groups in future.

BackgroundStudies assessing the impacts of China’s New-type Rural Cooperative Medical Scheme (NCMS) reform of 2003 among rural elderly have been limited.MethodMultistage stratified cluster sampling household surveys of 1838, 1924, 1879, 1888, 1890 and 1896 households from 27 villages in Jiangxi province were conducted in 2003/2004, 2006, 2008, 2010, 2012 and 2014. Data from older adults age 65 and above were analyzed. Weighted logistic regression was applied to find factors of elderly hospitalization services.ResultsSince 2003, hospitalization rates for elderly increased, while rates of patients leaving against medical advice and patients avoiding the hospital decreased (P < 0.05). Factors associated with a higher likelihood of reporting hospitalization in the past year for elderly were the per-capita financial level V in 2012 for NCMS (Adjusted Odds Ratios [aOR]: 2.295), the level VI in 2014 (aOR: 3.045) versus the level I in 2003 and chronic disease (aOR: 2.089) versus not having a chronic disease. Lower rate of elderly left against medical advice was associated with the financial level V in 2012 (aOR: 0.099) versus the level I. The higher rate of hospital avoidance was associated with chronic disease status (aOR: 5.759) versus not having a chronic disease, while the lower rate was associated with the financial level VI in 2014 (aOR: 0.143) versus the level I. Among reporting reasons for elderly hospital avoidance, the cost-related reasons just dropped slightly over the years.ConclusionsNCMS improved access to health services for older adults. The utilization of hospitalization services for rural elderly increased gradually, but cost-related barriers remained the primary reporting barrier to accessing hospitalization services.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1638-5) contains supplementary material, which is available to authorized users.