ArticleBMJ open2021
Effect of critical illness insurance on the medical expenditures of rural patients in China: an interrupted time series study for universal health insurance coverage.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 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
- The cost of dengue shock and septic shock in Vietnam: a patient-centred economic analysis.International health · 2026Observational
- Financial Toxicity in Neuromyelitis Optica Spectrum Disorder: An ABC-X Mixed-Methods Study.Brain and behavior · 2026Article
- The analysis of the leukemia mortality rate and its temporal trends in China from 2004 to 2021.BMC public health · 2026Article
- The mental health effects of critical illness insurance: Evidence from China's aging population.PloS one · 2025Article
- Healthcare Expenditures among the Elderly in China: The Role of Catastrophic Medical Insurance.International journal of environmental research and public health · 2022Article
- Interrupted time series analysis for the impact of integrated medical insurance on direct hospitalization expense of catastrophic illness.Scientific reports · 2022Article
- China Promotes Sanming's Model: A National Template for Integrated Medicare Payment Methods.International journal of integrated careArticle
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe objective of this study is to determine if critical illness insurance (CII) promotes the universal health coverage to reduce out-of-pocket (OOP) medical expenditures and improve the effective reimbursement rate (ERR) in rural China. STUDY
designThe 5-year monthly hospitalisation data, starting 2 years before the CII (ie, the 'intervention') began, were collected. Interrupted time series analysis models were used to evaluate the immediate and gradual effects of CII on OOP payment and ERR.
settingThe study was conducted in Xiantao County, Hubei Province, China.
participantsA total of 511 221 inpatients within 5 years were included in the analysis.
resultsIn 2016, 100 288 patients received in-patient services, among which 4137 benefited from CII. After the implementation of CII, OOP expenses increased 32.2% (95% CI 24.8% to 39.5%, p<0.001). Compared with the preintervention periods, the trend changes decline at a rate of 0.7% per month after the implementation of CII. Similarly, a significant decrease was observed in log ERR after the intervention started. The rate of level change is 16% change (95% CI -20.0% to -12.1%, p<0.001).
conclusionCII did not decrease the OOP payments of rural inpatients in 2011-2016 periods. The limited extents of population coverage and financing resources can be attributed to these results. Therefore, the Chinese government must urgently raise the funds of CII and improve the CII policy reimbursement rate.
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