ArticleBMJ global health2020
Ten years of progress towards universal health coverage: has China achieved equitable healthcare financing?
Article in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 29 citations in OpenAlex.
- Plan-related inequalities in costs, disease progression and mortality among hypertensive patients in China.Nature communications · 2026Article
- Equity in health financing in China: a national financing and benefit incidence analysis, 2013-2023.The Lancet regional health. Western Pacific · 2026Article
- [Associations of subjective perceptions and income change with transitions in usual source of care among Chinese residents: A study based on China Family Panel Studies].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2026Observational
- Fiscal Incentives and Health Risk Protection: How Central-Local Fiscal Relations Shape Rural Households' Medical Burden in China.Healthcare (Basel, Switzerland) · 2026Article
- Association of DRG-based payment reform with inpatient costs and resource use among older adults: an interrupted time series study in a county-level referral hospital in China.Frontiers in public health · 2026Article
- Dynamic effects of outpatient pooling scheme on socioeconomic inequality in healthcare utilization in China from 2011 to 2020.Scientific reports · 2025Article
- Socioeconomic gradients and mechanisms of chronic disease health literacy: the mediating role of preventive healthcare utilization in rural Shangdong, China.International journal for equity in health · 2025Article
- Income-related benefit mobility before and after Urban and Rural Resident Basic Medical Insurance integration: a longitudinal analysis of China.BMC health services research · 2025Article
- East Meets West: A Multisite Validity Study of the China Medical Professionalism Inventory.Perspectives on medical education · 2025Article
- Efficiency of the healthcare system and the impact of smoking bans: a DEA analysis of the Guangdong-Hong Kong-Macau Greater Bay Area in Asia.Frontiers in public health · 2025Article
- Capacity for the management of kidney failure in the International Society of Nephrology North and East Asia region: report from the 2023 ISN Global Kidney Health Atlas (ISN-GKHA).Kidney international supplements · 2024Review
- The effect of urban-rural resident basic medical insurance on physical health of the rural older adult in China.Frontiers in public health · 2024Article
- Trends in the availability of community-based home visiting services for oldest-old in China, 2005-2018.BMJ open · 2023Article
- Trends and projections of universal health coverage indicators in China, 1993-2030: An analysis of data from four nationwide household surveys.The Lancet regional health. Western Pacific · 2023Article
- Article
- Can Basic Medical Insurance Reduce Elderly Family Income Inequality in China?Frontiers in public health · 2022Article
- Factors associated with health care utilization and catastrophic health expenditure among cancer patients in China: Evidence from the China health and retirement longitudinal study.Frontiers in public health · 2022Article
- Community-based health financing: empirical evaluation of the socio-demographic factors determining its uptake in Awka, Anambra state, Nigeria.International journal for equity in health · 2021Article
- Age-Related Disease Burden in China, 1997-2017: Findings From the Global Burden of Disease Study.Frontiers in public health · 2021Article
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThis study aims to systematically evaluate vertical and horizontal equity in the Chinese healthcare financing system over the period 2008-2018 during the progress towards Universal Health Coverage (UHC), and to examine how both types of equity have changed during this period.
methodsHousehold information on healthcare payments was collected from 2398 households involving 7021 individuals in 2008, 3600 households involving 10 466 individuals in 2013 and 3660 households involving 11 550 individuals in 2018. Redistributive effects of healthcare financing system were decomposed into progressivity, pure horizontal inequity and reranking. Progressivity analysis and the Aronson-Johnson-Lambert decomposition method were adopted to measure the vertical equity and horizontal equity of healthcare financing.
resultsOver the period 2008-2018, healthcare financing through indirect taxes showed a slightly prorich structure and healthcare financing through direct taxes showed a propoor structure in both urban and rural areas. Urban Employee Basic Medical Insurance experienced redistribution from the poor to the rich during the period 2008-2013, but then experienced redistribution from the rich to the poor during the period 2013-2018. Urban Resident Basic Medical Insurance (URBMI), New Rural Cooperative Medical Scheme (NRCMS), Urban and Rural Resident Basic Medical Insurance (URRBMI) and out-of-pocket payments experienced redistribution from the poor to the rich over the entire period.
conclusionChina's healthcare financing has experienced redistribution from the poor to the rich during 10 years of progress toward the UHC. UHC improved access to and utilisation of healthcare in urban areas. The flat rate contribution mechanism should be renovated for URBMI, NRCMS and URRBMI.
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