ArticleBMJ open2017
Perceived challenges to achieving universal health coverage: a cross-sectional survey of social health insurance managers/administrators in China.
Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Challenges to Achieving Universal Health Coverage Throughout the World: A Systematic Review.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2022Pooled it
- Who benefits more from an improved social health insurance? Evidence from supplementary high-cost illness insurance in China.BMC health services research · 2026Article
- Incidence and costs of cervical spondylosis in urban China from 2013 to 2017: a nationwide population-based study.The Lancet regional health. Western Pacific · 2026Article
- Factors and key problems influencing insured's poor perceptions of convenience of basic medical insurance: a mixed methods research of a northern city in China.BMC public health · 2023Article
- Identifying Patient Perceptions of Inequality in Public Health Care Services: Evidence From a Single Indian Administrative District.Journal of patient-centered research and reviews · 2023Article
- Perceptions of the benefits of the basic medical insurance system among the insured: a mixed methods research of a northern city in China.Frontiers in public health · 2023Article
- Universal health coverage evolution, ongoing trend, and future challenge: A conceptual and historical policy review.Frontiers in public health · 2023Article
- Experiences and Challenges of Implementing Universal Health Coverage With China's National Basic Public Health Service Program: Literature Review, Regression Analysis, and Insider Interviews.JMIR public health and surveillance · 2022Review
- Healthy Community-Life Circle Planning Combining Objective Measurement and Subjective Evaluation: Theoretical and Empirical Research.International journal of environmental research and public health · 2022Article
- Health-related quality of life of patients with haemophilia: a cross-sectional survey in the Northeast of China.BMJ open · 2022Article
- Universality of universal health coverage: A scoping review.PloS one · 2022Article
- Successes and obstacles in implementing social health insurance in developing and middle-income countries: A scoping review of 5-year recent literatures.Frontiers in public health · 2022Article
- Building a global community of shared future free from poverty.Global health journal (Amsterdam, Netherlands) · 2021Article
- Challenges faced by community health nurses to achieve universal health coverage in Myanmar: A mixed methods study.International journal of nursing sciences · 2021Article
- Benefit of China's Social Health Insurance Schemes: Trend Analysis and Associated Factors Since Health Reform.International journal of environmental research and public health · 2021Article
- Prevalence of mammary Paget's disease in urban China in 2016.Scientific reports · 2021Article
- Incidence of gastrointestinal stromal tumor in Chinese urban population: A national population-based study.Cancer medicine · 2021Article
- Analyzing the Financial Sustainability of User Fee Removal Policies: A Rapid First Assessment Methodology with a Practical Application for Burkina Faso.Applied health economics and health policy · 2020Article
- Spatiotemporal Analysis of Influenza in China, 2005-2018.Scientific reports · 2019Article
- Antihypertensive drugs use over a 5-year period among children and adolescents in Beijing, China: An observational study.Medicine · 2019Observational
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveChina has achieved over 96% health insurance coverage. However, universal health coverage (UHC) entails population coverage and the range of services covered and the extent to which health service costs are covered. This study aimed to determine the performance of the health insurance system in China in terms of its role in UHC and to identify challenges in the progress of UHC as perceived by health insurance managers/administrators.
methodsA cross-sectional questionnaire survey was conducted in Beijing, Ningbo, Harbin and Chongqing over the period of 2014 and 2015. A stratified cluster random sampling strategy was adopted to select study participants. A total of 1277 (64.8%) respondents who reported familiarity with the current health insurance system and the requirements of UHC provided valid data for analyses. They gave a rating on the role of the current health insurance system in achieving UHC. A multivariate logistic regression model was developed to determine the associations between the rating and the features of insurance arrangements.
resultsThere was consensus among the respondents on the performance of the current health insurance system in terms of its role in UHC, regardless who they were and what responsibility they held in their organisation (ie, policy development, managing fund transactions, and so on). Overall, about 45% of the respondents believed that there is a long way to go to achieve UHC. The low rating was found to be associated with limited financial protection (OR=1.656, 95% CI 1.279 to 2.146), healthcare inequity (OR=1.607, 95% CI 1.268 to 2.037), poor portability (OR=1.347, 95% CI 1.065 to 1.703) and ineffective supervision and administration of funds (OR=1.339, 95% CI 1.061 to 1.692) as perceived by the respondents.
conclusionHealth insurance managers/administrators in China are pessimistic about the achievements of the current health insurance system. They are concerned about the overall lack of benefit that insurance programmes bring to members, including low levels of entitlements, large healthcare inequity, limited financial protection and poor portability. A singular amendment of the structural design of the existing funds may not be enough to offer a satisfactory solution to these identified barriers. There is a need to increase funding capacities, to develop unified and consistent policies and to increase the level of fund pooling.
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