ArticleBMC health services research2020
Analysis of the effect of serious illness medical insurance on relieving the economic burden of rural residents in China: a case study in Jinzhai County.
Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Assessing intervention effects on healthcare-related financial protection in low- and middle-income countries: a rapid evidence review.Health policy and planning · 2026Review
- Medical insurance payment schemes and patient medical expenses: a cross-sectional study of lung cancer patients in urban China.BMC health services research · 2023Article
- Perspectives and evaluation on the effect of financial burden relief of medical insurance for people with catastrophic diseases and its influencing factors.Frontiers in public health · 2023Article
- Access to innovative drugs and the National Reimbursement Drug List in China: Changing dynamics and future trends in pricing and reimbursement.Journal of market access & health policy · 2023Article
- Healthcare Expenditures among the Elderly in China: The Role of Catastrophic Medical Insurance.International journal of environmental research and public health · 2022Article
- Research on the design of serious illness insurance scheme in Shanghai based on micro-simulation.BMC health services research · 2022Article
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Authors and funding
3 authors.
Funding
Abstract
backgroundIn 2003, China established a New Rural Cooperative Medical System (NRCMS) for rural residents to alleviate the burden of medical expenses among rural residents. However, its reimbursement for high medical costs was insufficient. Therefore, China gradually established the Serious Illness Insurance System (SIMIS) based on NRCMS. After receiving payment through NRCMS, patients in rural areas who met the requirements of SIMIS policy would receive a second payment for their high medical expenses. This study aimed to analyze the effect of the implementation of SIMIS on alleviating the economic burden of rural residents in Jinzhai County.
methodsThe study used the inpatient reimbursement data of NRCMS in Jinzhai County, Anhui Province, from 2013 to 2016. We adopted descriptive and regression discontinuity (RD) methods to analyze the payment effect of SIMIS. The RD analysis targeted patients (n = 7353) whose annual serious illness expenses were between CNY 10,000 (1414 USD) and CNY 30,000 (4242 USD), whereas the descriptive analysis was used for data of the patients compensated by SIMIS (n = 2720).
resultsThe results of RD showed that the actual medical insurance payment proportion increased by about 2.5% (lwald = 0.025, P < 0.01), inside medical insurance self-payment proportion increased by about 2% (lwald = 0.020, P < 0.10), and outside medical insurance self-payment proportion decreased by about 1.6% (lwald = - 0.016, P < 0.05). The descriptive results showed that patients with serious illnesses mostly chose to go to a hospital outside the county. The annual average number of hospitalizations was 3.64. The reimbursement mainly came from the NRCMS. The payment amount of SIMIS was relatively small, and the out-of-pocket medical expenses were still high.
conclusionThe medical technology level of Jinzhai County could not meet the needs of patients with seriously illnesses, the number of beneficiaries of SIMIS was small, and the ability to relieve the burden of medical expenses of the rural residents was insufficient. The high out-of-pocket expenses increased the possibility that only people with good economic conditions could benefit from the reimbursement of SIMIS, resulting in inequity.
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