Can the New Cooperative Medical Scheme promote rural elders' access to health‐care services?

Abstract

The aim of the present study was to examine the impact of the New Cooperative Medical Scheme (NCMS) on rural elders' access to health-care services. Articles were identified from PubMed, Elsevier, Wiley, EBSCO, EMBASE, SCI Expanded, ProQuest, Google, and CNKI which is the most informative database in Chinese, with the search terms "rural", "China", "old", "older", or "elder", "elderly", or "aged", "aging", "medical insurance", or "community-based medical insurance", or "cooperative medical scheme". Related websites and yearbooks were searched as well. The NCMS has improved the health-care utilization of rural elders, and they have the highest satisfaction with it among all age groups. However, affordability difficulty remained the common barrier for the rural elderly to access quality health care, in spite of the special considerations given to the rural elderly, such as premium remission and free check-ups. Faced with ever-growing health challenges, some impoverished rural elders with poor physical health and functional limitations may lack sufficient access to basic health-care services. Followed by the provider payment reform initiated by the NCMS, a stricter regulation for doctors' prescriptions, clinical practice and disease management is needed to promote rural elders' access to health-care services. Health management for rural elders can be expected for the NCMS to promote rural elders' health-care access once a better coordination between the NCMS and health-care system can be achieved.

Family Caregiver's Perception of Alzheimer's Disease and Caregiving in Chinese Culture

“…That is, the offspring has responsibilities to care for elders (filial piety) and the same generation (e.g., spouse and sibling) should care for each other in the extended family (Dai, Zhou, & Mei, 2013;Dai, Zhou, Mei, Wu, & Mao, 2011). By implementing these family responsibilities, Chinese set an example to the offspring and get positive feelings (e.g., satisfaction) from family caregiving.…”

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“…20 A literature review concluded that NCMS increased healthcare utilization by rural elders, but that affordability challenges remained, especially among the poorest. 21 Another study of NCMS' impact found an increased use of preventive care, but not of formal healthcare services. 22 Studies to date have also reported conflicting evidence on the effects of NCMS on risk protection.…”

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“…China's BNMI system reform is advancing steadily, including BNMI coverage expansion, and has achieved remarkable results; however, there are also deficiencies in the system. China's BNMI system mainly comprises the urban resident basic medical insurance and the rural cooperative medical insurance [23,24,25,26]. The BNMI system covers more than 1 billion of the country's 1.3 billion populations, as a report issued by the Ministry of Health showed [27].…”