Did expansion of health insurance coverage reduce horizontal inequity in healthcare finance? A decomposition analysis for China.
Adolescent
Adult
Child
Child, Preschool
China
Cross-Sectional Studies
Delivery of Health Care
/ economics
Family Characteristics
Female
Health Care Costs
/ statistics & numerical data
Health Equity
/ economics
Health Expenditures
/ statistics & numerical data
Humans
Infant
Infant, Newborn
Insurance Coverage
/ economics
Male
Middle Aged
Rural Population
Socioeconomic Factors
Urban Population
Young Adult
financing
health insurance
horizontal inequity
payment
redistributive effect
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
09 01 2019
09 01 2019
Historique:
entrez:
21
2
2019
pubmed:
21
2
2019
medline:
20
2
2020
Statut:
epublish
Résumé
'Horizontal inequity' in healthcare finance occurs when people with equal income contribute unequally to healthcare payments. Prior research is lacking on horizontal inequity in China. Accordingly, this study set out to examine horizontal inequity in the Chinese healthcare financing system in 2002 and 2007 through two rounds of national household health surveys. Two rounds of cross-sectional study. Heilongjiang Province, China. Adopting a multistage stratified random sampling, 3841 households with 11 572 individuals in 2003 and 5530 households with 15 817 individuals in 2008 were selected. The decomposition method of Aronson Over the period 2002-2007, the absolute value of horizontal inequity in total healthcare payments decreased from 93.85 percentage points to 35.50 percentage points in urban areas, and from 113.19 percentage points to 37.12 percentage points in rural areas. For public health insurance, it increased from 17.84 percentage points to 28.02 percentage points in urban areas, and decreased from 127.93 percentage points to 0.36 percentage points in rural areas. Horizontal inequity in out-of-pocket payments decreased from 79.92 percentage points to 24.83 percentage points in urban areas, and from 127.71 percentage points to 53.10 percentage points in rural areas. Our results show that horizontal inequity in total healthcare financing decreased over the period 2002-2007 in China. In addition, out-of-pocket payments contributed most to the extent of horizontal inequity, which were reduced both in urban and rural areas over the period 2002-2007.
Identifiants
pubmed: 30782750
pii: bmjopen-2018-025184
doi: 10.1136/bmjopen-2018-025184
pmc: PMC6340012
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e025184Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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