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Paying for outpatient care in rural China: cost escalation under China’s New Co-operative Medical Scheme

Yang, Wei, Wu, Xun (2014) Paying for outpatient care in rural China: cost escalation under China’s New Co-operative Medical Scheme. Health Policy and Planning, 29 (1). ISSN 0268-1080. E-ISSN 1460-2237. (doi:10.1093/heapol/czt111) (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided) (KAR id:38300)

The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided. (Contact us about this Publication)
Official URL
http://dx.doi.org/10.1093/heapol/czt111

Abstract

China’s New Co-operative Medical Scheme (NCMS), a government-subsidized health insurance programme, was launched in 2003 in response to deterioration in access to health services in rural areas. Initially designed to cover inpatient care, it has begun to expand its benefit package to cover outpatient care since 2007. The impacts of this initiative on outpatient care costs have raised growing concern, in particular regarding whether it has in fact reduced out-of-pocket (OOP) payments for services among rural participants. This study investigates the impacts on outpatient costs by analysing data from an individual-level longitudinal survey, the China Health and Nutrition Survey, for 2004 and 2009, years shortly before and after NCMS began coverage of outpatient services in 2007. Various health econometrics strategies were employed in the analysis of these data, including the Two-Part Model, the Heckman Selection Model and Propensity Score Matching with the Differences-in-Differences model, to estimate the effects of the 2007 NCMS initiative on per episode outpatient costs. We find that NCMS outpatient coverage starting in 2007 had little impact on reducing its participants’ OOP payments for outpatient services. The new coverage may also have contributed to an observed increase in total per episode outpatient costs billed to the insured patients. This increase was more pronounced among village clinics and township health centres—the backbone of the health system for rural residents—than at county and municipal hospitals.

Item Type: Article
DOI/Identification number: 10.1093/heapol/czt111
Uncontrolled keywords: NCMS, outpatient costs, health care cost, inflation, China
Subjects: H Social Sciences > HJ Public Finance
R Medicine > RA Public aspects of medicine
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Personal Social Services Research Unit
Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tony Rees
Date Deposited: 14 Feb 2014 15:07 UTC
Last Modified: 29 May 2019 11:51 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/38300 (The current URI for this page, for reference purposes)
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