ArticleHealth economics review2022
The comparison of catastrophic health expenditure and its inequality between urban and rural households in China.
Article in Health economics review, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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26 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Catastrophic health expenditure and associated factors in low-, lower-middle and upper-middle-income countries: systematic review and meta-analysis.Global health action · 2026Pooled it
- The impact of family health resources on the economic risk of diseases in rural China: based on a path analysis.BMC public health · 2026Article
- Has volume-based procurement reduced household catastrophic health expenditure in rural patients with chronic disease?-Evidence from CHARLS 2018 and 2020 in China.Health economics review · 2026Article
- From individual burden to social risk pooling: drivers of the declining out-of-pocket health expenditure share in China (2009-2024).International journal for equity in health · 2026Article
- Household financial management behavior and catastrophic health expenditure risk in rural China: the moderating role of health insurance coverage.Frontiers in public health · 2026Article
- Willingness to pay for supplementary medical insurance and its influencing factors among rural residents in ethnic minority areas.Frontiers in public health · 2026Article
- Equity of total health expenditure in China, 2015-2021.Scientific reports · 2025Article
- Prevalence and Intensity of Catastrophic Health Expenditure Among Residents in a Multiethnic Province in China: Cross-Sectional Study.JMIR public health and surveillance · 2025Article
- Determinants of medical borrowing and associated inequalities in the Kingdom of Saudi Arabia: evidence from the Global Findex survey.Health economics review · 2025Article
- Can supplementary private health insurance reduce vulnerability to expected poverty and catastrophic health expenditure in China?International journal for equity in health · 2025Article
- Psychological constructs and preferences for a complementary inclusive health insurance: a hybrid choice model.Health policy and planning · 2025Article
- Can supplementary private health insurance reduce poverty vulnerability? Evidence from Shandong Province.BMC public health · 2025Article
- The effect of health insurance reimbursement rates on middle-aged and elderly people's hospital choices: evidence from China.Health economics review · 2025Article
- Spatio-temporal patterns and determinants of persistent catastrophic health expenditure in China: evidence from the China Family Panel Studies.Frontiers in public health · 2025Article
- Socioeconomic inequality in financial hardship in accessing quality healthcare services in Ethiopia: a community-based cross-sectional study.Frontiers in public health · 2025Article
- GIS-based assessment of spatial and temporal disparities of urban health index in Shenzhen, China.Frontiers in public health · 2024Article
- Socioeconomic Inequalities in Out-of-Pocket and Catastrophic Health Expenditures in Pakistan.International journal of public health · 2024Article
- Laos' Social Health Insurance (SHI) program's impact on older people's accessibility and financial security against catastrophic health expense.BMC health services research · 2023Article
- 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
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Abstract
backgroundIn recent years, the goal of universal coverage of the basic medical insurance schemes has been basically achieved in China, but the heavy economic burden of diseases is still the main cause of poverty in many households. Exploring catastrophic health expenditure (CHE) and its inequality are highly important for forward-looking policymaking. This study aims to compare the incidence, intensity and inequality of CHE between urban and rural households in China.
methodsThis study was based on a national representative household survey-the China Family Panel Studies (CFPS)-that was conducted from 2012 to 2018. Concentration index (CI) was employed to measure the inequality of CHE incidence and overshoot, while the decomposition method of the CI was used to estimate the main influencing factors affecting inequality of CHE incidence.
resultsFrom 2012 to 2018, the CHE incidence of urban households increased from 11.01 to 11.88%, while the CHE incidence of rural households decreased from 18.42 to 18.31%. During the same period, the CI of CHE incidence for urban households decreased from - 0.1480 to - 0.1693, while that for rural households declined from - 0.1062 to - 0.1501. The major contribution to the pro-poor inequality in CHE incidence was associated with socioeconomic status, lagged CHE, receiving inpatient services, having elderly members, education of household head, and self-assessed health status of household head.
conclusionsRural households had higher risk of incurring CHE than urban households. The strong pro-poor inequality for CHE incidence and overshoot could be found in both two groups. The problem of poverty due to illness was more severe among low-income groups in rural areas than in urban areas. The relevant policy interventions should further focus on encouraging the development of supplementary medical insurance and increasing the reimbursement rate for hospitalization expenses in the medical assistance system.
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