A decomposition analysis of recent health expenditure growth in China: is population ageing a significant effecting factor?

Zhai, Tiemin; Wan, Quan; Chai, Peipei; Guo, Feng; Li, Yan; Wang, Rongrong; Chen, Chunmei; Li, Tao; Gao, Runguo

doi:10.1007/s42379-020-00058-2

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…While China is actively improving universal health coverage (UHC), its drug expenditures are increasing every year, similar to many countries in the world 1‐4 . According to the China National Health Development Research Center in 2019, the average annual increase in China's health expenditures reached 11% (2009–2018), and the increasing trend ranked first in Asia 5 . In 2020, China's total health expenditure was approximately 115.41 billion USD, accounting for 7.12% of the GDP 6 .…”

Section: What Is Known and Objectivementioning

confidence: 99%

“…[1][2][3][4] According to the China National Health Development Research Center in 2019, the average annual increase in China's health expenditures reached 11% (2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018), and the increasing trend ranked first in Asia. 5 In 2020, China's total health expenditure was approximately 115.41 billion USD, accounting for 7.12% of the GDP. 6 Similar to the United States, the rising cost of prescription drugs has become one of the factors leading to the serious burden on China's health insurance system.…”

Section: What Is K Nown and Objec Tivementioning

confidence: 99%

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Impact of the National Centralized Drug Procurement Policy (4 + 7 policy) on the drug expenditures of patients treated in outpatient and emergency departments in a large tertiary level‐A hospital in China: A single centre, interrupted time series

Lan

Guan

Pang

et al. 2021

Clinical Pharmacy Therapeu

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Summary What is known and objective Like many countries in the world, China is also facing growing drug expenditures year by year. In particular, the rising cost of prescription drugs has been one of the critical factors leading to the serious burden on health insurance programs. The high cost of prescription drugs not only threatens the health budget but also limits the nation's investment in other public sectors. China implemented the National Centralized Drug Procurement (NCDP) policy, also known as the "4 + 7" policy, in tertiary hospitals in various provinces and cities across the country on 18 December 2019, aiming to lessen personal and national health insurance burdens by reducing drug procurement prices. The aim of this study is to explore the impact of the implementation of the NCDP policy on the drug expenditures of patients treated in outpatient and emergency departments and on national health insurance expenditures. Methods This study adopts interrupted time series (ITS) to evaluate the impact of China's implementation of the NCDP policy on the drug expenditures of patients treated in outpatient and emergency departments in a tertiary hospital. The NCDP policy was officially implemented on 18 December 2019. A segmented regression model is utilized to analyse the average monthly drug expenditures of patients treated in outpatient and emergency departments from January 2018 to June 2021, including the average monthly per‐visit drug expenditures of all patients and the average monthly per‐visit drug expenditures of patients who paid for drugs with health insurance and those who did not use health insurance. Results After the implementation of the NCDP policy, the overall average monthly per‐visit drug expenditures of patients treated in outpatient and emergency departments were immediately reduced by 233.954 CNY (p < 0.01). Compared with the continued downward trend for drug expenditures before the implementation of the NCDP policy, the long‐term trend after policy implementation was not obvious (p = 0.051973>0.05). Similarly, the average monthly per‐visit drug expenditures of patients treated in outpatient and emergency departments who use health insurance to procure drugs also immediately decreased by 505.287 CNY (p < 0.01), but the long‐term trends before (p = 0.469>0.05) and after policy implementation (p = 0.51>0.05) did not exhibit obvious change. For the average monthly per‐visit drug expenditures of patients treated in outpatient and emergency departments who did not use health insurance, the implementation of the NCDP policy did not produce an immediate reduction in drug expenditures (p = 0.3603>0.05). Although the average monthly per‐visit drug expenditures decreased by 9.078 CNY (p < 0.01) before policy implementation, this trend ended after the policy was implemented (p = 0.0735>0.05), and no other changes were triggered. What is new and conclusion This study reviews the data for a period of time before and after the implementation of the NCDP policy. The policy is shown to significantly dec...

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Section: What Is Known and Objectivementioning

confidence: 99%

Section: What Is K Nown and Objec Tivementioning

confidence: 99%

Impact of the National Centralized Drug Procurement Policy (4 + 7 policy) on the drug expenditures of patients treated in outpatient and emergency departments in a large tertiary level‐A hospital in China: A single centre, interrupted time series

Lan

Guan

Pang

et al. 2021

Clinical Pharmacy Therapeu

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show abstract

“…In recent years, China’s health expenditure has been growing, and the proportion of total health expenditure in terms of gross domestic product (GDP) is on the rise. 3 Studies have shown that the curative expenditure in China accounts for 75.59% of current health expenditure (CHE), which indicates that health expenditure is mostly on treatment and rehabilitation, and less on prevention. 4 5 This finding contradicts the goal of disease prevention in the Healthy China 2030 Plan, which emphasises the prevention and treatment of diseases.…”

Section: Introductionmentioning

confidence: 99%

Case study of the beneficiary group distribution of curative care expenditure based on SHA 2011 in Xinjiang autonomous region, China

Feng

Pan

et al. 2021

BMJ Open

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BackgroundThe System of Health Accounts 2011 (SHA 2011) assists in health policy analysis and health expenditure comparison at the international level. Based on SHA 2011, this study analysed the distribution of beneficiary groups of curative care expenditure (CCE) in Xinjiang, to present suggestions for developing health policies.MethodsA total of 160 health institutions were selected using the multistage stratified random sampling method. An analysis of the agewise CCE distribution, institutional flow, and disease distribution was then performed based on the SHA 2011 accounting framework.ResultsIn 2016, the CCE in Xinjiang was ¥50.05 billion, accounting for 70.18% of current health expenditure and 6.66% of the gross domestic product. The per capita CCE was ¥2366.56. The CCE was distributed differently across age groups, with the highest spending on people over the age of 65 years. The CCE was highest for diseases of the circulatory, respiratory and digestive systems. Most of the expenditure was incurred in hospitals and, to a lesser extent, in primary healthcare institutions. Family health expenditure, especially on children aged 14 years and below, accounted for a relatively high proportion of the CCE.ConclusionSHA 2011 was used to capture data, which was then analysed according to the newly added beneficiary dimension. The findings revealed that the use of medical resources is low, the scale of primary medical institutions needs to be significantly expanded and there is a need to optimise the CCE financing scheme. Therefore, the health policymaking department should optimise the relevant policies and improve the efficiency of health services.

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“…However, some scholars have suggested that population ageing has little effect on THE. In a study, 21.2% of the THE growth was driven by population ageing [ 36 ]. Wang et al (2017) verified the weak effect of increased ageing on out-of-pocket payments through a vector autoregressive model [ 37 ].…”

Section: Population Ageing and Sustainability Of Medicare Fundmentioning

confidence: 99%

Population ageing and sustainability of healthcare financing in China

Wu,

Long,

Cerda

et al. 2023

Cost Eff Resour Alloc

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Background In China, the healthcare financing structure involves multiple parties, including the government, society and individuals. Medicare Fund is an important way for the Government and society to reduce the burden of individual medical costs. However, with the aging of the population, the demand of Medicare Fund is increasing. Therefore, it is necessary to explore the sustainability of the healthcare financing structure in the context of population ageing. Objective The purpose of this paper is to organize the characteristics of population ageing as well as healthcare financing in China. On this basis, it analyzes the impact mechanism of population ageing on healthcare financing and the sustainability of existing healthcare financing. Methods This paper mainly adopts the method of literature research and inductive summarization. Extracting data from Health Statistics Yearbook of China and Labor and Social Security Statistics Yearbook of China. Collected about 60 pieces of relevant literature at home and abroad. Results China has already entered a deeply ageing society. Unlike developed countries in the world, China's population ageing has distinctive feature of ageing before being rich. A healthcare financing scheme established by China, composing of the government, society, and individuals, is reasonable. However, under the pressure of population ageing, China's current healthcare financing scheme will face enormous challenges. Scholars are generally pessimistic about the sustainability of China's healthcare financing scheme. Conclusions Population ageing will increase the expenditure and reduce the income of the Medicare Fund. This will further affect the sustainability of the healthcare financing structure. As a consequence, the state should pay particular attention to this issue and take action to ensure that the Fund continues to operate steadily.

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A decomposition analysis of recent health expenditure growth in China: is population ageing a significant effecting factor?

Cited by 4 publications

References 9 publications

Impact of the National Centralized Drug Procurement Policy (4 + 7 policy) on the drug expenditures of patients treated in outpatient and emergency departments in a large tertiary level‐A hospital in China: A single centre, interrupted time series

Impact of the National Centralized Drug Procurement Policy (4 + 7 policy) on the drug expenditures of patients treated in outpatient and emergency departments in a large tertiary level‐A hospital in China: A single centre, interrupted time series

Case study of the beneficiary group distribution of curative care expenditure based on SHA 2011 in Xinjiang autonomous region, China

Population ageing and sustainability of healthcare financing in China

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