SynthesisPloS one2020
Do health insurances reduce catastrophic health expenditure in China? A systematic evidence synthesis.
Synthesis in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Access to health insurance amongst people with disabilities and its association with healthcare use, health status and financial protection in low- and middle-income countries: a systematic review.International journal for equity in health · 2024Pooled it
- Catastrophic health expenditure, incidence, trend and socioeconomic risk factors in China: A systematic review and meta-analysis.Frontiers in public health · 2022Pooled it
- A study on the current status of collaboration between China's commercial health insurance and medical institutions and improvement strategies.BMC health services research · 2026Article
- Out-of-pocket health expenditures and financial protection in Türkiye: pre-pandemic (2019) and COVID-19 era (2022) microdata.BMC health services research · 2026Article
- Multidimensional health poverty among diabetic adults in China: evidence from the China Kadoorie Biobank.Archives of public health = Archives belges de sante publique · 2026Article
- Financial protection and healthcare utilization for low-income populations under China's multi-tiered health financing system: a cross-sectional study in an Eastern city.BMC health services research · 2026Article
- Health Insurance Schemes and Chronic Disease Management Behaviours in China: Evidence from Women with Non-Communicable Diseases.Risk management and healthcare policy · 2026Article
- Factors influencing the decision to opt out of basic medical insurance among China's migrant population: a logistic regression analysis.Frontiers in public health · 2026Article
- The impact of DRG payment reform on stroke inpatient costs: a propensity score matching and difference-in-differences analysis of a large public hospital in Northeast China.BMC public health · 2025Article
- Disease burden and health-related quality of life among children with X-linked hypophosphataemia in China: a national cross-sectional survey.BMJ paediatrics open · 2025Article
- Does younger children's social health insurance alleviate household impoverishment due to illness?BMC health services research · 2024Article
- Catastrophic health expenditure and its association with socioeconomic status in China: evidence from the 2011-2018 China Health and Retirement Longitudinal Study.International journal for equity in health · 2023Article
- Changes in health care utilization and financial protection after integration of the rural and urban social health insurance schemes in Beijing, China.BMC health services research · 2022Article
- Trends in disparities in healthcare utilisation between and within health insurances in China between 2008 and 2018: a repeated cross-sectional study.International journal for equity in health · 2022Article
- The impact of ethnic minority status on tuberculosis diagnosis and treatment delays in Hunan Province, China.BMC infectious diseases · 2022Article
- Health Insurance and Out-Of-Pocket Expenditure on Health and Medicine: Heterogeneities along Income.Frontiers in pharmacology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo examine the association of health insurances on catastrophic health expenditure (CHE), and compares that among different health insurances in the last two decades in China.
methodsThe systematic review was conducted according to the Cochrane Handbook and reported according to PRISMA. We searched English and Chinese literature databases including PubMed, EM base, web of science, CNKI, Wan fang, VIP and CBM (Sino Med) for empirical studies on the association between health insurance and CHE from January 2000 to June 2020. Study selection, data extraction and quality appraisal were conducted by two reviewers. The secular trend of CHE rate and comparisons between population with different health insurances were conducted using meta-analysis, subgroup analysis and meta-regression.
resultsA total of 4874 citations were obtained, and finally 30 eligible studies with 633917 participants were included. The overall CHE rate was 13.6% (95% CI: 13.1% - 14.0%) from Jan 2000 to June 2020, 12.8% (95% CI: 12.2% - 13.3%) for people with health insurance compared with 16.2% (95% CI:15.4% - 16.9%) for people without health insurance. For types of insurance, the CHE rate was 13.0% (95% CI: 12.4% - 13.6%) for people with new rural cooperative medical scheme (NCMS), 11.9% (95% CI: 9.3% - 14.5%) for urban employees health insurance (UEBMI), 12.0% (95% CI: 8.3% - 15.6%) for urban residents health insurance (URBMI), and 18.0% (95% CI: - 4.5% - 31.5%) for commercial insurance. However, the CHE rate in China has increased in the past 20 years, even adjusted for other factors. The CHE rate of people with NCMS has increased significantly more than people with UEBMI and URBMI.
conclusionIn the past 20 years, the basic health insurance plan has reduce the rate of CHE to a certain extent, but due to the rapid increase in medical costs and the release of health needs in recent years, it masks the role of health insurance. More efforts are needed to control unreasonable medical demand and rising costs.
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