Perceived effect of financial risk protection by the Urban–Rural Resident Basic Medical Insurance Scheme: a mixed-methods study of rural residents in China

Abstract

ObjectivesIt is to explore the perceived financial risk protection effect of the Urban–Rural Resident Basic Medical Insurance Scheme (URRBMI) and its influencing factors to provide evidence to further improve the URRBMI.DesignIt is a cross-sectional survey.ParticipantsThis mixed-methods study is conducted in five provinces in rural China. Through stratified cluster random sampling, 1681 rural residents participate in a cross-sectional questionnaire survey (1657 valid questionnaires are retrieved). Thirty rural residents participate in in-depth interviews.Primary and secondary outcome measuresA multivariate logistic regression analysis is adopted to identify factors influencing respondents’ perceptions. Semistructured interviews are used to identify the reasons why some respondents believed the URRBMI to be ineffective.ResultsOverall, 77.5% of respondents believe that the URRBMI is effective. Respondents, who are older, have a higher household income, prefer primary health facilities and provide a higher rating for critical illness compensation and maximum compensatory payouts. They are more likely to give the URRBMI a higher effectiveness rating than their counterparts. Qualitatively, participants who believe the URRBMI to be ineffective list the following reasons: low outpatient service coverage, insufficient or undersupplied drugs and services in the insurance list, problems in the arrangement of deductibles and maximum compensatory payouts, provider-induced behaviour and increased healthcare service price.ConclusionsThis exploration focuses on the reasons why rural residents think the scheme is invalid, which are vital for policy reform. Policies should focus on benefits design and coverage, the assumption of a supervisory role, avoiding financial risk stemming from critical illness and cross-sectoral actions to strengthen the primary healthcare system and comprehensive social security wealth.

Perceptions of the benefits of the basic medical insurance system among the insured: a mixed methods research of a northern city in China

“…Additionally, many researchers have asserted that factors such as "financial burden, convenience, equity, regulation, utility, information awareness, and recognition" can significantly affect the insured's experience of the use of medical insurance (11,16,(33)(34)(35)(36)(37). Jiang et al (38) suggested that the "health status" of the insured is also a key factor in the perceptions of benefits. Moreover, Sadak et al and Sanogo et al (39,40) have shown that the experience of the insured is fundamental to evaluating the perceptions of medical insurance benefits.…”

Can Basic Medical Insurance Reduce Elderly Family Income Inequality in China?

“…Referring to the previous literature ( 13 , 38 , 41 ), we construct the following model to test the impact of basic medical insurance on elderly family income inequality.…”

Factors influencing the prescription pattern of essential medicines from the perspectives of general practitioners and patients: a qualitative study in China

“…In 2016, NRCMS and URBMI were integrated as the Urban-Rural Resident Basic Medical Insurance Scheme (URRBMI). 13 14 The medical aid system provides double benefits to the poor; this includes subsidising their enrolment in basic medical insurance and providing cash assistance to reimburse their medical expenditures. 15 As a supplement to the basic medical insurance system, commercial medical insurance covers out-of-pocket medical expenses after reimbursement by the basic medical insurance, as well as various insurance products beyond the coverage of basic medical insurance, such as the medical second option, advanced registration and VIP ward reimbursement.…”

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