Development and enrolee satisfaction with basic medical insurance in China: A systematic review and stratified cluster sampling survey

Jing, Limei; Chen, Ru; Jing, Lisa; Qiao, Yun; Lou, Jiquan; Xu, Jiawei; Wang, Junwei; Chen, Wen; Sun, Xiaoming

doi:10.1002/hpm.2430

Cited by 23 publications

(19 citation statements)

References 17 publications

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“…Essentially, a ‘15-min medical treatment circle’ has been formed to reduce distance and time taken for residents to obtain health services [ 22 ]. To ensure that urban and rural residents enjoy equal access to basic medical care, China has established a medical security system covering 1.3 billion people, with a participation of over 95% [ 23 ]. The basic medical insurance system for urban workers has also been implemented, and the insurance premium is jointly paid by the unit and individual workers (accounting for 9 % and 2% of the monthly salary, respectively).…”

Section: Introductionmentioning

confidence: 99%

Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage

Zheng

et al. 2021

IJERPH

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Worldwide countries are recognising the need for and significance of universal health coverage (UHC); however, health inequality continues to persist. This study evaluates the status and equity of residents’ demand for and utilisation of health services and expenditure by considering the three components of universal health coverage, urban-rural differences, and different income groups. Sample data from China’s Fifth Health Service Survey were analysed and the ‘five levels of income classification’ were used to classify people into income groups. This study used descriptive analysis and concentration index and concentration curve for equity evaluation. Statistically significant differences were found in the demand and utilisation of health services between urban and rural residents. Rural residents’ demand and utilisation of health services decreased with an increase in income and their health expenditure was higher than that of urban residents. Compared with middle- and high-income rural residents, middle- and lower-income rural residents faced higher hospitalisation expenses; and, compared with urban residents, equity in rural residents’ demand and utilisation of health services, and annual health and hospitalisation expenditures, were poorer. Thus, equity of health service utilisation and expenditure for urban and rural residents with different incomes remain problematic, requiring improved access and health policies.

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Section: Introductionmentioning

confidence: 99%

Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage

Zheng

et al. 2021

IJERPH

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“…Integrated basic medical insurance has changed the health resource structure and health security system. Analyzing the factors that influence satisfaction with URRBMI will help to optimize the service mechanisms and promote the reform of the medical insurance system [ 15 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Mixed methods research on satisfaction with basic medical insurance for urban and rural residents in China

et al. 2020

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Background: There have been few studies on satisfaction with integrated basic medical insurance for urban and rural residents (URRBMI), and satisfaction with URRBMI is not very high because of the complexity of its policies and differences among the insured. The aim of the present study was to explore the factors that influence satisfaction with URRBMI in China and to provide scientific suggestions to the government for how to effectively manage and improve the policy. Methods: An explanatory sequential design of mixed methods research was used. A quantitative research using a three-stage stratified cluster sampling method was used to randomly select the guardians of pupils who participated in URRBMI (n = 1335). The quantitative research was conducted to calculate the latent variables' scores and path coefficients between latent variables using SmartPLS3.0. With public trust, public satisfaction, and perceived quality as the target variables, important-performance analysis (IPA) was used to explore the important but underperforming factors, which were the key elements to improving satisfaction with URRBMI. A purposeful sampling strategy according to satisfaction level was used to obtain qualitative research subjects from among the quantitative research subjects. A qualitative research was conducted using semi-structured interviews, and the thematic analysis method was used to summarize the interview data. Results: The three strongest paths were perceived quality to public satisfaction, with a total effect of 0.737 (t = 41.270, P < 0.001); perceived quality to perceived value, with a total effect of 0.676 (t = 31.964, P < 0.001); and public satisfaction to public trust, with a total effect of 0.634 (t = 31.305, P < 0.001). IPA revealed that public satisfaction and perceived quality were key factors for public trust and that perceived quality was of high importance for public satisfaction but had low performance. The policy quality was a determining factor for perceived quality. The qualitative research results showed that the most unsatisfactory aspect for the insured was the policy quality.

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“…40 Chinese hospital enrollee satisfaction has improved by introducing a mixed payment system and maintaining sequential medical orders. 42…”

Section: China's Health Financing Reformmentioning

confidence: 99%

Government health expenditure, out‐of‐pocket payment and social inequality: A cross‐national analysis of China and OECD countries

Zhang

Rahman

2020

Health Planning & Management

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This study aims to assess the association between Chinese out‐of‐pocket payments and government health spending, investigating their variation ratio in the context of OECD countries. Aggregated time‐series data of 37 countries (from China and official OECD members) were collected from the World Bank Open Data source and analyzed using the multiple linear regression models. Benchmarking approach was applied to evaluate the causes of healthcare expenditure rise per capita. The results showed that China's government health expenditure was positively associated with out‐of‐pocket payment rise, with a higher variation score of 42.70%. The association was statistically significant at 5%. Likewise, the association between government expenditure and out‐of‐pocket payment in the OECD countries was positively significant at 1%, and their variation score was 2.41%. Health financing in OECD countries showed higher stability and equity than that in China. Policy implications for China is to reduce the distributional disparity of government health funds by tax adjustments in health services, universal health coverage, the removal of social health insurance disparities, and a single health payment method.

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Development and enrolee satisfaction with basic medical insurance in China: A systematic review and stratified cluster sampling survey

Cited by 23 publications

References 17 publications

Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage

Equity of Health Services Utilisation and Expenditure among Urban and Rural Residents under Universal Health Coverage

Mixed methods research on satisfaction with basic medical insurance for urban and rural residents in China

Government health expenditure, out‐of‐pocket payment and social inequality: A cross‐national analysis of China and OECD countries

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