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Developing a Basic Medical Insurance Statement in Chinese Underdeveloped Areas

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      Abstract

      Background:We presented the running state of rural basic medical insurance system in Henan and discussed the enforcements and development experiences of underdeveloped areas. We provided data evidence to support the improvement and development of a basic rural medical insurance system.Methods:We selected Henan Province, China as a sample, using the method of cluster sampling, from policy documents published in the national and provincial level of the new rural cooperative medical policy and work documents, data from 2004 to 2014, the National Health Statistical Yearbook of health statistics yearbook of Henan Province and relevant statistical data of the province.Results:The new rural cooperative policy has covered the whole population in Henan Province. The number of individual received benefits is increasing. In 2013, the number of persons counted has reached to 270 million, funds raised and expenditures reached 38.5 billion and 26 billion, respectively. The operational task force has been developed rapidly. In 2013, on average each staff managed the cases for 16.4 thousand rural residents.Conclusion:The major implementation and development experience from the new rural cooperative policy of Henan province include: education of related knowledge, optimization of compensation plan, development of operational system and framework, improvement of management rules, reinforcement of information system development and financial supervision and increment of investment in rural medical healthcare.

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      Extending health insurance to the rural population: an impact evaluation of China's new cooperative medical scheme.

      In 2003, China launched a heavily subsidized voluntary health insurance program for rural residents. We combine differences-in-differences with matching methods to obtain impact estimates, using data collected from program administrators, health facilities and households. The scheme has increased outpatient and inpatient utilization, and has reduced the cost of deliveries. But it has not reduced out-of-pocket expenses per outpatient visit or inpatient spell. Out-of-pocket payments overall have not been reduced. We find heterogeneity across income groups and implementing counties. The program has increased ownership of expensive equipment among central township health centers but has had no impact on cost per case.
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        Effects of changes in health insurance reimbursement level on outpatient service utilization of rural diabetics: evidence from Jiangsu Province, China

        Background Outpatient reimbursement levels of the New Rural Cooperative Medical Scheme have changed in recent years in China, and those changes may have a greater impact on patients with chronic diseases due to their higher outpatient expenses. This study represents the first attempt to identify the effects of reimbursement level on outpatient service utilization for chronic patients in rural China and it also gives strong estimation results by conducting a tracer illness study in order to control for possible biases associated with studying several diseases together. Methods This study used difference-in-differences models to examine how changes in yearly maximum reimbursement amount and outpatient reimbursement rates affected rural residents with type 2 diabetes in three counties in Jiangsu Province, China. Other factors, such as sex, age and severity of illness, were also included in the model estimations. To make sure the treated group and control group are comparable, Propensity Score Match (PSM) was used to analysis the gender, age and severity of illness of the two groups. Results The results indicate that an increase in yearly maximum reimbursement amount for outpatient visits could cause an increase in yearly total outpatient expenses for patients with type 2 diabetes mellitus. However, changes in outpatient reimbursement rates between 2010 and 2011 did not significantly affect the utilization of different types of health institution. Conclusions The reimbursement rates of village clinics should be substantially increased from the existing basis and the gap of reimbursement rates among different institutions should be further widened. It is also important for village clinics to improve their services. Moreover, measures to improve the quality of care and scope of services at lower-level healthcare institutions, and promote the health service utilization of rural women should be considered.
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          Great efforts are needed to develop primary medical service in China: correcting the mistranslation of “Primary Health Care” as the first step

           Guoping Xu (corresponding) (2014)
          This article aims to discuss how the mistranslation of “Primary Health Care” takes an adverse effect on the conceptual understanding of primary medical service and the development of medical and health services in mainland China. The mistranslation of “Primary” among the public, leadership, and scholars in the field of medicine can lead to a misunderstanding on the real concept as “entry level.” Therefore, it is of significant importance to dispel the misunderstanding and free our minds so as to vigorously develop the primary health care and general practice system.
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            Author and article information

            Affiliations
            [1. ] Institute of Medical Information, Chinese Academy of Medical Sciences, Beijing, China
            [2. ] Medical College of Hebei Engineering University, Handan, Hebei, China
            Author notes
            [* ] Corresponding Author: Email: xu_yanli9@ 123456163.com
            Journal
            Iran J Public Health
            Iran. J. Public Health
            IJPH
            IJPH
            Iranian Journal of Public Health
            Tehran University of Medical Sciences
            2251-6085
            2251-6093
            April 2018
            : 47
            : 4
            : 489-498
            5996335
            ijph-47-489
            Copyright© Iranian Public Health Association & Tehran University of Medical Sciences

            This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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