Urban-rural differences in catastrophic health expenditure among households with chronic non-communicable disease patients : evidence from China Family Panel Studies

Abstract

Background: The prevalence of chronic non-communicable diseases (NCDs) challenges the Chinese health system reform. Little is known for the differences in catastrophic health expenditure (CHE) between urban and rural households with NCD patients. This study aims to measure the differences above and quantify the contribution of each variable in explaining the urban-rural differences.Methods: The second and the fourth waves of the China Family Panel Studies (CFPS) data, conducted in 2012 and 2016, were employed in this cross-sectional study. The techniques of Fairlie nonlinear decomposition and Blinder-Oaxaca decomposition were employed to measure the contribution of each independent variable to the urban-rural differences.Results: The CHE incidence and intensity of households with NCD patients were significantly higher in rural areas than in urban areas. The explained disparity of CHE incidence increased from 3.15% in 2012 to 27.04% in 2016, and the corresponding values of CHE intensity rose from 21.30% in 2012 to 53.37% in 2016. The major contribution to the urban-rural differences in CHE was associated with household economic status, education level, health status and supplementary medical insurance (SMI).Conclusions: Compared with urban households with NCD patients, rural households with NCD patients have higher risk of incurring CHE and heavier economic burden of diseases. Policy interventions should give priority to decreasing the urban-rural disparity in observable characteristics.