The effects of China’s New Cooperative Medical Scheme on accessibility and affordability of healthcare services: an empirical research in Liaoning Province

Abstract

BackgroundChina’s New Cooperative Medical Scheme (NCMS), launched in 2003, was intended to prevent the impoverishment due to catastrophic illness costs. Previous studies have been conducted on the “design flows” of the NCMS, for example, the irrational insurance benefit package. But after several years of implementation, very little has been known about the improvements made by the NCMS and rural residents’ attitudes toward it. This article specifically focused on the improvements of healthcare services and the enrollees’ choices of providers since the implementation of the NCMS in Liaoning province.MethodsWe conducted a one-on-one interview with healthcare officials in order to get a better understanding of the NCMS policies of the local area. We conducted a door-to-door survey in 3 counties, 21 villages and 602 households to gauge population characteristics, respondents’ healthcare preferences, satisfaction levels with providers, and their attitudes towards designated healthcare institutions.ResultsWe found that 43.6% of the respondents believed the NCMS brought more convenience to receive healthcare services. 35.2% of the rural residents thought the NCMS work ineffectively, mainly due to the high healthcare costs. 72.3% of the respondents preferred the county hospitals when they got severe diseases, mainly for the reason of better skills and more advanced equipment, while they preferred village clinics (56.5%) and township hospitals (23.2%) when they got minor diseases mainly for the reason of convenience.ConclusionWe concluded that the NCMS improved the situation of hard to receive healthcare services but did not reduce the high healthcare fees. Furthermore, participants were unsatisfied with the NCMS designated hospitals. Based on our findings, a number of remedial actions were proposed, including redistributing healthcare resources, developing more domestic medical equipment to lower the treatment costs, and establishing a new talent flow mode.

Study on the Utilization of Inpatient Services for Middle-Aged and Elderly Rural Females in Less Developed Regions of China

“…The medical security system is known to have an impact on the use of inpatient services [23,31,32]. Some studies have shown that patients enrolled in NRCM are more likely to seek health care services [2,[33][34][35]. The NRCM got started in Jiangxi Province in 2003, and Wuyuan, Xiushui, and Luxi counties were randomly selected for this study to examine the impact of this new system in 2005.…”

“…Thus, the less developed region is the main focus in this phase. How to improve the health level of rural residents in less developed areas and achieve equalization of medical and health services have been a major concern [2][3][4].…”

Economic burden of gastrointestinal cancer under the protection of the New Rural Cooperative Medical Scheme in a region of rural China with high incidence of oesophageal cancer: cross‐sectional survey

“…Through years of development, the security level and coverage of the scheme have been greatly increased. Although study results are inconclusive on whether the NCMS has lightened the financial burden for rural residents, the scheme has improved the situation of hard‐to‐receive healthcare services . The NCMS provides a representative model for all countries, especially for developing countries, which face fewer resources and a heavy healthcare burden.…”

Physical examination service utilization among seasonal immigrants in Sanya, China: a cross-sectional study

“…28 However, we can't get the same result, that could be explained that since in 2003 China introduced New Cooperative Medical Scheme, which enhanced the financing standard and reduced the burden for the low income families. 29 but the logistic regression model display age wasn't the influencing factor. But in the model we find the AOR of age over 80 is 1.81 and the AOR95%CL was 0.80-4.07 which was a wide confidence interval.…”