Targeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the middle age and elderly population?
Abstract Background In light of the health poverty alleviation policy, we explore whether the New Rural Cooperative Medical System (NRCMS) has effectively reduced the economic burden of medical expenses on rural middle-aged and elderly people and other impoverished vulnerable groups. The study aims...
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| Format: | Article |
| Language: | English |
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BMC
2020-09-01
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| Series: | International Journal for Equity in Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12939-020-01236-x |
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| author | Nianshi Wang Jing Xu Meiyan Ma Linghan Shan Mingli Jiao Qi Xia Wanxin Tian Xiyu Zhang Limin Liu Yanhua Hao Lijun Gao Qunhong Wu Ye Li |
| author_facet | Nianshi Wang Jing Xu Meiyan Ma Linghan Shan Mingli Jiao Qi Xia Wanxin Tian Xiyu Zhang Limin Liu Yanhua Hao Lijun Gao Qunhong Wu Ye Li |
| author_sort | Nianshi Wang |
| collection | DOAJ |
| description | Abstract Background In light of the health poverty alleviation policy, we explore whether the New Rural Cooperative Medical System (NRCMS) has effectively reduced the economic burden of medical expenses on rural middle-aged and elderly people and other impoverished vulnerable groups. The study aims to provide evidence that can be used to improve the medical insurance system. Methods Data were obtained from the 2015 China Health and Retirement Longitudinal Study (CHARLS). The method of calculating the catastrophic health expenditure (CHE) and impoverishment by medical expense (IME) was adopted from the World Health Organization (WHO). The treatment effect model was used to identify the determinants of CHE for rural middle-aged and elderly people. Results The incidence of CHE in rural China for middle-aged and elderly people is 21.8%, and the IME is 8.0%. The households that had enrolled in the NRCMS suffered higher CHE (21.9%) and IME (8.0%), than those that had not enrolled (CHE: 20.6% and IME: 7.7%). The NRCMS did not provide sufficient economic protection from CHE for households with three or more chronic diseases, inpatients, or households with members aged over 65 years. Key risk factors for the CHE included education levels, households with inpatients, households with members aged over 65 years, and households with disabilities. Conclusions Although the NRCMS has reduced barriers to the usage of household health services by reducing people’s out-of-pocket payments, it has not effectively reduced the risk of these households falling into poverty. Our research identifies the characteristics of vulnerable groups that the NRCMS does not provide enough support for, and which puts them at a greater risk of falling into poverty due to health impoverishment. |
| first_indexed | 2024-12-12T02:17:04Z |
| format | Article |
| id | doaj.art-90cfad5ee8514945b053cd60d254bb79 |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-12-12T02:17:04Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-90cfad5ee8514945b053cd60d254bb792022-12-22T00:41:46ZengBMCInternational Journal for Equity in Health1475-92762020-09-0119111310.1186/s12939-020-01236-xTargeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the middle age and elderly population?Nianshi Wang0Jing Xu1Meiyan Ma2Linghan Shan3Mingli Jiao4Qi Xia5Wanxin Tian6Xiyu Zhang7Limin Liu8Yanhua Hao9Lijun Gao10Qunhong Wu11Ye Li12Policy and Management Research Center, School of Health Management, Department of Social Medicine, School of Public Health, Harbin Medical UniversityHeilongjiang Provincial HospitalPolicy and Management Research Center, School of Health Management, Department of Social Medicine, School of Public Health, Harbin Medical UniversityPolicy and Management Research Center, School of Health Management, Department of Social Medicine, School of Public Health, Harbin Medical UniversityPolicy and Management Research Center, School of Health Management, Department of Social Medicine, School of Public Health, Harbin Medical UniversityPolicy and Management Research Center, School of Health Management, Department of Social Medicine, School of Public Health, Harbin Medical UniversityPolicy and Management Research Center, School of Health Management, Department of Social Medicine, School of Public Health, Harbin Medical UniversityPolicy and Management Research Center, School of Health Management, Department of Social Medicine, School of Public Health, Harbin Medical UniversityThe Second Affiliated Hospital of Harbin Medical UniversityPolicy and Management Research Center, School of Health Management, Department of Social Medicine, School of Public Health, Harbin Medical UniversityPolicy and Management Research Center, School of Health Management, Department of Social Medicine, School of Public Health, Harbin Medical UniversityPolicy and Management Research Center, School of Health Management, Department of Social Medicine, School of Public Health, Harbin Medical UniversityPolicy and Management Research Center, School of Health Management, Department of Social Medicine, School of Public Health, Harbin Medical UniversityAbstract Background In light of the health poverty alleviation policy, we explore whether the New Rural Cooperative Medical System (NRCMS) has effectively reduced the economic burden of medical expenses on rural middle-aged and elderly people and other impoverished vulnerable groups. The study aims to provide evidence that can be used to improve the medical insurance system. Methods Data were obtained from the 2015 China Health and Retirement Longitudinal Study (CHARLS). The method of calculating the catastrophic health expenditure (CHE) and impoverishment by medical expense (IME) was adopted from the World Health Organization (WHO). The treatment effect model was used to identify the determinants of CHE for rural middle-aged and elderly people. Results The incidence of CHE in rural China for middle-aged and elderly people is 21.8%, and the IME is 8.0%. The households that had enrolled in the NRCMS suffered higher CHE (21.9%) and IME (8.0%), than those that had not enrolled (CHE: 20.6% and IME: 7.7%). The NRCMS did not provide sufficient economic protection from CHE for households with three or more chronic diseases, inpatients, or households with members aged over 65 years. Key risk factors for the CHE included education levels, households with inpatients, households with members aged over 65 years, and households with disabilities. Conclusions Although the NRCMS has reduced barriers to the usage of household health services by reducing people’s out-of-pocket payments, it has not effectively reduced the risk of these households falling into poverty. Our research identifies the characteristics of vulnerable groups that the NRCMS does not provide enough support for, and which puts them at a greater risk of falling into poverty due to health impoverishment.http://link.springer.com/article/10.1186/s12939-020-01236-xHealth poverty alleviationNew rural cooperative medical systemVulnerable populationMiddle-aged and elderly peopleChina |
| spellingShingle | Nianshi Wang Jing Xu Meiyan Ma Linghan Shan Mingli Jiao Qi Xia Wanxin Tian Xiyu Zhang Limin Liu Yanhua Hao Lijun Gao Qunhong Wu Ye Li Targeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the middle age and elderly population? International Journal for Equity in Health Health poverty alleviation New rural cooperative medical system Vulnerable population Middle-aged and elderly people China |
| title | Targeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the middle age and elderly population? |
| title_full | Targeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the middle age and elderly population? |
| title_fullStr | Targeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the middle age and elderly population? |
| title_full_unstemmed | Targeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the middle age and elderly population? |
| title_short | Targeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the middle age and elderly population? |
| title_sort | targeting vulnerable groups of health poverty alleviation in rural china what is the role of the new rural cooperative medical scheme for the middle age and elderly population |
| topic | Health poverty alleviation New rural cooperative medical system Vulnerable population Middle-aged and elderly people China |
| url | http://link.springer.com/article/10.1186/s12939-020-01236-x |
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