Impact of new rural cooperative medical scheme on the equity of health services in rural China

Abstract

BackgroundTo explore the equity in health services in the rural areas, by studying the rural residents in two counties of Ningbo City, Zhejiang.MethodsMulti-stage stratified cluster random sampling method was performed to draw the study sample. Trained investigators conducted face to face interviews using a questionnaire. Rural residents were stratified into 5 income groups. Centralized index (CI) and risk ratios (RR) were used to assess the equity in health services and the impact of the New Cooperative Medical Scheme (NCMS).ResultsThe centralized index of the 2 weeks prevalence, two-week visiting rate and chronic disease prevalence among different income groups was − 0.0264, − 0.0076 and − 0.0160, respectively, while that of the hospitalization rate was 0.0006. The highest NCMS coverage rate, adjusted risk of disease and catastrophic health expenditure (CHE) rates were observed in lowest income groups (92.86, 4.94 and 32.21%, respectively. Two-week prevalence, chronic diseases prevalence and RR showed a declining trend with increasing income levels.ConclusionNCMS has improved the service availability and reduced the economic burden of diseases. However, its impact on reducing the economic risk of illness and promoting equity in health services has not been significant.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3288-2) contains supplementary material, which is available to authorized users.

<p>The Effect of New Rural Cooperative Medical Scheme on the Socioeconomic Inequality in Inpatient Service Utilization Among the Elderly in China</p>

“…Chen et al found that the effect of NRCMS on promoting equity in health services has not been significant. 13 In contrast, the study of Feng and Liu suggests that NRCMS has a positive contribution in increasing the pro-poor inequality in health-care utilization. 14 Furthermore, a study which is conducted by Zhou et al reveals that health insurance has effectively reduced the income-related inequality in inpatient service utilization for the residents in China.…”

Environmental challenges from the increasing medical waste since SARS outbreak

“…The increase in beds has enabled more patients to be effectively treated, and hospitalizations increased from 60 million in 2002 to 250 million in 2018 ( Figure 1 B). The popularity of basic medical insurance (7% of the population in 2002 increased to 96% in 2018) ( Figure 1 C) has also led to more opportunities for treatment ( Figure 2 ), especially in rural ( Chen et al, 2018 ; Dai et al, 2016 ), and the visits reached 5.5 billion in 2018 (increased nearly 160% compared to 2002).…”

Trend of disparity between coastland and inland in medical expenditure burden for rural inpatients with malignant tumor in southeast of China from 2007 to 2016

“…With the development of economy, the per capita disposable income and health awareness of residents increased so that the residents would go to hospital when they were ill [19,20]. In addition, the unceasing improvement of NRCMS promoted the participation rate increasing which also resulted in the rise of hospital admissions [21,22].…”