Universal Health Insurance Coverage and the Economic Burden of Disease in Eastern China: A Pooled Cross-Sectional Analysis From the National Health Service Survey in Jiangsu Province
China has achieved universal social health insurance coverage, but it is unclear whether this has alleviated the economic burden of disease for individuals. This was investigated in the present study by analyzing National Health Service Survey (2008–2018) data from Jiangsu province. Ordinary least s...
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Frontiers Media S.A.
2022-02-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.738146/full |
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| author | Shenping Zhou Chenyu Zhou Chenyu Zhou Qin Yuan Zhonghua Wang Zhonghua Wang Zhonghua Wang |
| author_facet | Shenping Zhou Chenyu Zhou Chenyu Zhou Qin Yuan Zhonghua Wang Zhonghua Wang Zhonghua Wang |
| author_sort | Shenping Zhou |
| collection | DOAJ |
| description | China has achieved universal social health insurance coverage, but it is unclear whether this has alleviated the economic burden of disease for individuals. This was investigated in the present study by analyzing National Health Service Survey (2008–2018) data from Jiangsu province. Ordinary least squares and binary multivariate logistic regression of pooled cross-sectional data were carried out to evaluate the effect of universal health insurance coverage and other socioeconomic factors on the economic burden of disease. Total health expenses (THE) first increased and then decreased during the survey period while out-of-pocket health expenses (OOP) decreased except for urban residents, for whom OOP increased after 2013. Household catastrophic health expenditure (HCHE) was stable between 2008 and 2013 but increased after 2013. Social health insurance had a significant positive effect on the annual THE and OOP and a negative effect on HCHE, however, universal health insurance coverage could alleviated THE and the economic burden of disease on individuals (OOP) while it was insufficient to protect against the economic risk of diseases (HCHE), with greater benefits for urban as compared to rural residents. Other socioeconomic factors including age, marital status, education, income, and health status also influenced the economic burden of disease. |
| first_indexed | 2024-04-11T18:00:09Z |
| format | Article |
| id | doaj.art-c61bb32ab36f478e92cdff5e03b490cf |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-11T18:00:09Z |
| publishDate | 2022-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-c61bb32ab36f478e92cdff5e03b490cf2022-12-22T04:10:33ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-02-011010.3389/fpubh.2022.738146738146Universal Health Insurance Coverage and the Economic Burden of Disease in Eastern China: A Pooled Cross-Sectional Analysis From the National Health Service Survey in Jiangsu ProvinceShenping Zhou0Chenyu Zhou1Chenyu Zhou2Qin Yuan3Zhonghua Wang4Zhonghua Wang5Zhonghua Wang6School of Health Policy Management, Nanjing Medical University, Nanjing, ChinaSchool of Health Policy Management, Nanjing Medical University, Nanjing, ChinaInstitute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, ChinaSchool of Health Policy Management, Nanjing Medical University, Nanjing, ChinaSchool of Health Policy Management, Nanjing Medical University, Nanjing, ChinaThe Public Health Policy and Management Innovation Research Team, Nanjing Medical University, Nanjing, ChinaCenter for Global Health, Nanjing Medical University, Nanjing, ChinaChina has achieved universal social health insurance coverage, but it is unclear whether this has alleviated the economic burden of disease for individuals. This was investigated in the present study by analyzing National Health Service Survey (2008–2018) data from Jiangsu province. Ordinary least squares and binary multivariate logistic regression of pooled cross-sectional data were carried out to evaluate the effect of universal health insurance coverage and other socioeconomic factors on the economic burden of disease. Total health expenses (THE) first increased and then decreased during the survey period while out-of-pocket health expenses (OOP) decreased except for urban residents, for whom OOP increased after 2013. Household catastrophic health expenditure (HCHE) was stable between 2008 and 2013 but increased after 2013. Social health insurance had a significant positive effect on the annual THE and OOP and a negative effect on HCHE, however, universal health insurance coverage could alleviated THE and the economic burden of disease on individuals (OOP) while it was insufficient to protect against the economic risk of diseases (HCHE), with greater benefits for urban as compared to rural residents. Other socioeconomic factors including age, marital status, education, income, and health status also influenced the economic burden of disease.https://www.frontiersin.org/articles/10.3389/fpubh.2022.738146/fulluniversal health insurance coverageeconomic burden of diseasetotal health expense (THE)out-of-pocket health expense (OOP)household catastrophic health expenditure (HCHE) |
| spellingShingle | Shenping Zhou Chenyu Zhou Chenyu Zhou Qin Yuan Zhonghua Wang Zhonghua Wang Zhonghua Wang Universal Health Insurance Coverage and the Economic Burden of Disease in Eastern China: A Pooled Cross-Sectional Analysis From the National Health Service Survey in Jiangsu Province Frontiers in Public Health universal health insurance coverage economic burden of disease total health expense (THE) out-of-pocket health expense (OOP) household catastrophic health expenditure (HCHE) |
| title | Universal Health Insurance Coverage and the Economic Burden of Disease in Eastern China: A Pooled Cross-Sectional Analysis From the National Health Service Survey in Jiangsu Province |
| title_full | Universal Health Insurance Coverage and the Economic Burden of Disease in Eastern China: A Pooled Cross-Sectional Analysis From the National Health Service Survey in Jiangsu Province |
| title_fullStr | Universal Health Insurance Coverage and the Economic Burden of Disease in Eastern China: A Pooled Cross-Sectional Analysis From the National Health Service Survey in Jiangsu Province |
| title_full_unstemmed | Universal Health Insurance Coverage and the Economic Burden of Disease in Eastern China: A Pooled Cross-Sectional Analysis From the National Health Service Survey in Jiangsu Province |
| title_short | Universal Health Insurance Coverage and the Economic Burden of Disease in Eastern China: A Pooled Cross-Sectional Analysis From the National Health Service Survey in Jiangsu Province |
| title_sort | universal health insurance coverage and the economic burden of disease in eastern china a pooled cross sectional analysis from the national health service survey in jiangsu province |
| topic | universal health insurance coverage economic burden of disease total health expense (THE) out-of-pocket health expense (OOP) household catastrophic health expenditure (HCHE) |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.738146/full |
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