ArticleBMJ open2019
Did expansion of health insurance coverage reduce horizontal inequity in healthcare finance? A decomposition analysis for China.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Equity in health financing in China: a national financing and benefit incidence analysis, 2013-2023.The Lancet regional health. Western Pacific · 2026Article
- Socioeconomic-related inequities in child immunization: horizontal and vertical dimensions for policy insights.Health economics review · 2024Article
- Ten years of progress towards universal health coverage: has China achieved equitable healthcare financing?BMJ global health · 2020Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectives'Horizontal inequity' in healthcare finance occurs when people with equal income contribute unequally to healthcare payments. Prior research is lacking on horizontal inequity in China. Accordingly, this study set out to examine horizontal inequity in the Chinese healthcare financing system in 2002 and 2007 through two rounds of national household health surveys.
designTwo rounds of cross-sectional study.
settingHeilongjiang Province, China.
participantsAdopting a multistage stratified random sampling, 3841 households with 11 572 individuals in 2003 and 5530 households with 15 817 individuals in 2008 were selected.
methodsThe decomposition method of Aronson
findingsOver the period 2002-2007, the absolute value of horizontal inequity in total healthcare payments decreased from 93.85 percentage points to 35.50 percentage points in urban areas, and from 113.19 percentage points to 37.12 percentage points in rural areas. For public health insurance, it increased from 17.84 percentage points to 28.02 percentage points in urban areas, and decreased from 127.93 percentage points to 0.36 percentage points in rural areas. Horizontal inequity in out-of-pocket payments decreased from 79.92 percentage points to 24.83 percentage points in urban areas, and from 127.71 percentage points to 53.10 percentage points in rural areas.
conclusionsOur results show that horizontal inequity in total healthcare financing decreased over the period 2002-2007 in China. In addition, out-of-pocket payments contributed most to the extent of horizontal inequity, which were reduced both in urban and rural areas over the period 2002-2007.
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