Effects of China’s New Rural Cooperative Medical Scheme on reducing medical impoverishment in rural Yanbian: An alternative approach

Sun, Mei; Shen, Jay J.; Li, Chengyue; Cochran, Christopher; Wang, Ying; Chen, Fei; Li, Pingping; Lü, Jun; Chang, Fengshui; Li, Xiaohong; Hao, Mo

doi:10.1186/s12913-016-1660-7

Cited by 11 publications

(5 citation statements)

References 20 publications

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“…Furthermore, a recent study based on a national sample of rural residents from the 2011–2012 wave of China Health and Retirement Longitudinal Study (CHARLS) has shown that the coverage of NCMS associated with less delayed inpatient care [ 11 ]. Sun and his co-workers have recently demonstrated that the NCMS reduced the number of medically impoverished households by 24.6% in Yanbian [ 12 ]. Rural residents have greatly benefited from the implementation of the NCMS [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Impact of the New Cooperative Medical Scheme on the Rural Residents’ Hospitalization Medical Expenses: A Five-Year Survey Study for the Jiangxi Province in China

Xie

Jiang

Fang

et al. 2018

IJERPH

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This survey study was conducted to understand the effect of the New Cooperative Medical Scheme (NCMS) on farmers’ medical expenses through comparing the information from five investigations and to obtain a scientific basis for a more applicable NCMS. The survey was carried out through interviewing farmers in their homes. The multi-phase stratified cluster random sampling was adopted to select 3 counties from all 92 counties of the Jiangxi province, 9 townships from the 3 selected counties, 27 villages from the selected 9 townships, and 60 families from each village between 2006 and 2014, and a longitudinal comparative analysis was conducted. The numbers of households/overall sample for the five years were 1924/8082, 1879/8015, 1885/7506, 1890/7857, and 1896/7811, respectively. We collected family members’ social demographic characteristics, health resources, and peoples’ health and medical expenses and reimbursement of each family member. The adjusted hospitalization expenses per capita of township hospitals and county hospitals were totally on a rising trend. However, the costs of tertiary hospitals were on a decreasing tendency. In addition, the expenses for county hospitalization per admission were on an upward trend in general. Furthermore, the total hospitalization expenses and reimbursement per capita (the insurance paid out for the hospitalization expenses) were also all on an upward trend. The proportion of reimbursement also had a tendency of increasing from 24.41% in 2006 to 41.34% in 2014. The costs paid from farmers’ pockets were fluctuated, but in general all lower than the costs in 2006. Furthermore, the percentage of hospitalization expenses from farmers’ annual incomes gradually decreased each year from 56.38% in 2006 to 26.58% in 2014. NCMS program has had an obvious impact on the hospitalization expenses in the Jiangxi rural area. It reduced the hospitalization expenses of the tertiary hospitals significantly. In addition, the program has also encouraged farmers to get more health care. However, there are still some shortages associated with present construction of the NCMS. Hence, there is a need for local government to continue to take effective countermeasures to control the rising trend of hospitalization expense.

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Section: Introductionmentioning

confidence: 99%

Impact of the New Cooperative Medical Scheme on the Rural Residents’ Hospitalization Medical Expenses: A Five-Year Survey Study for the Jiangxi Province in China

Xie

Jiang

Fang

et al. 2018

IJERPH

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“…It indicated that economically affluent groups in the urban were more likely to receive advantageous finance reimbursements policy from independent insurance system, and meantime the reimbursements were also higher [ 21 ]. One study also showed that the implementation of essential medicines policies on primary healthcare institutions has certain positive but limited effects [ 22 ], which indicated that severe illness and impoverishment still occur like the twins in rural area [ 23 ]. Meanwhile, there were remarked difference in postoperative inflammation reaction among different medical insurance type only for mitral valve population but not for ASD occlusion population.…”

Section: Discussionmentioning

confidence: 99%

The impact of medical insurance reimbursement on postoperative inflammation reaction in distinct cardiac surgery from a single center

Jiang

Huang

et al. 2022

BMC Health Serv Res

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Background Evidences shows that socioeconomic status is reversely associated with the risk of morbidity and mortality for people with cardiovascular disease via pro-inflammation mechanism, but the population profile is not deeply defined on. We aimed to investigate the impact of medical insurance coverage on postoperative systemic inflammatory reaction in two kinds of disease populations undergoing distinct cardiac procedures. Methods A total of 515 patients receiving open mitral valve procedure with high-total expense from May 2013 through May 2021 in Sichuan Provincial People’s Hospital were retrospectively collected and stratified according to medical insurance reimbursement: low coverage with high out-pocket (< 30%), medium coverage (≤ 60%, but ≥ 30%), and high coverage (> 60%). Another 118 cases undergoing atrium septum defect (ASD) or patent foramen ovale (PFO) occlusion and taking on consistent low-total expense and low-coverage (< 30%) were also classified according to their insured conditions. The postoperative systemic inflammatory response indexes were high sensitivity C-reactive protein (hs-CRP) and the neutrophil–lymphocyte ratio (NLR). Results Low insurance reimbursement population undergoing open mitral valve procedure had a higher level of hs-CRP and NLR but not troponin I protein or lactate within 48 h postoperatively, and higher thoracic drainage, longer ventilation use and stay in intensive care unit. No significant difference in inflammatory indexes existed among diverse medical insurance coverage in population undergoing ASD/PFO occlusion. Conclusions Higher inflammatory reaction and weaker clinical recovery was associated with lower insurance coverage population undergoing open mitral valve procedure but not ASD/PFO interventional occlusion procedure.

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“…For rural patients, the medicine expenditure was found to have a negative impact on community clinic visits. By 2014, the reimbursement rate was only 60% for expenses for community health services in rural areas, meaning that medical care was a heavy economic burden [31].…”

Section: Discussionmentioning

confidence: 99%

Analysis of factors influencing the frequency of primary care visits among diabetic patients in two provinces in China

Wang

Zuo

Chen³

et al. 2019

BMC Public Health

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Background Community health services have played an important role in the prevention and control of diabetes in China. The aims of this study were to examine the frequency of visits to community clinics for diabetic care services, to assess factors correlated with infrequent primary care visits and to identify barriers to regular follow-up visits for urban and rural patients. Methods Between October 2014 and November 2014, data were collected from 17 communities in two cities and four townships located in Shandong and Jiangsu Provinces in China. A total of 1598 diabetic patients aged 18 years or older who were registered with a primary health station in local communities were selected by simple random sampling. Each participant was required to complete an interviewer-led questionnaire. Univariate and multivariate analyses were used to identify significant factors for infrequent visitor status using multivariable logistic regression analysis. Results After being clearly informed of the study protocol, 1508/1598 (94.4%) patients agreed to participate in this survey. Among the 1508 subjects (mean age 64.4 ± 10.6), 683 (45.3%) were classified as infrequent visitors. The following were significant factors determining infrequent visitor status: urban residence, lack of health insurance, per-capita household income< 20,000 (yuan), lack of telephone follow-up and lack of household visit. From the patients’ perspectives, the reasons for infrequent visits among urban patients included drug scarcity and longer travel time to clinics. For rural patients, worries about medical expenses and drug scarcity were the most common barriers to clinic visits. Conclusion Determinants of infrequent community visits in diabetes patients include urban residence, lower household income, lack of health insurance, lack of telephone follow-up and lack of household visit services. Strategies aimed at enhancing the utilization of community health care should be implemented in China.

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Effects of China’s New Rural Cooperative Medical Scheme on reducing medical impoverishment in rural Yanbian: An alternative approach

Cited by 11 publications

References 20 publications

Impact of the New Cooperative Medical Scheme on the Rural Residents’ Hospitalization Medical Expenses: A Five-Year Survey Study for the Jiangxi Province in China

Impact of the New Cooperative Medical Scheme on the Rural Residents’ Hospitalization Medical Expenses: A Five-Year Survey Study for the Jiangxi Province in China

The impact of medical insurance reimbursement on postoperative inflammation reaction in distinct cardiac surgery from a single center

Analysis of factors influencing the frequency of primary care visits among diabetic patients in two provinces in China

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