Extending Health Insurance to the Rural Population : An Impact Evaluation of China's New Cooperative Medical Scheme

Extending Health Insurance to the Rural Population : An Impact Evaluation of China's New Cooperative Medical Scheme

In 2003, after over 20 years of minimal health insurance coverage in rural areas, China launched a heavily subsidized voluntary health insurance program for rural residents. The authors use program and household survey data, as well as health facil...

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Bibliographic Details
Main Authors: Wagstaff, Adam, Lindelow, Magnus, Jun, Gao, Ling, Xu, Juncheng, Qian
Format: Policy Research Working Paper
Language:English
Published: World Bank, Washington, DC 2012
Subjects:
ADVERSE SELECTION
AGE STRUCTURE
AGRICULTURE
CITIES
COST CONTROL
COST-SHARING ARRANGEMENTS
DELIVERY SYSTEM
DEVELOPMENT RESEARCH GROUP
DISTRICTS
ECONOMIC DEVELOPMENT
ECONOMIES OF SCALE
EDUCATIONAL ATTAINMENT
EXPENDITURES
FAMILIES
FEE-FOR-SERVICE
GENDER
HEALTH CARE
HEALTH CARE PROVIDERS
HEALTH EXPENDITURES
HEALTH INSURANCE
HEALTH INSURANCE PROGRAM
HEALTH INSURANCE SCHEME
HEALTH SERVICES
HEALTH SPENDING
HEALTH STATUS
HEALTH SYSTEM
HOSPITALS
HOUSEHOLD EXPENDITURE
HOUSEHOLD INCOME
HOUSEHOLD LEVEL
HOUSEHOLD SIZE
HOUSEHOLD SURVEY
HOUSEHOLDS
INCOME DISTRIBUTION
INCOME GROUPS
INFORMAL SECTOR
INFORMAL SECTOR WORKERS
INSURERS
LOCAL GOVERNMENTS
MEDICAL SERVICES
MEDICAL SYSTEM
MORAL HAZARD
MORTALITY
NATIONAL HEALTH
NATIONAL HEALTH SERVICE
OCCUPANCY
OUTPATIENT CARE
POCKET PAYMENTS
POLICY RESEARCH
POOR HOUSEHOLDS
POSITIVE SPILLOVERS
PUBLIC HEALTH
PUBLIC HEALTH INSURANCE
QUALITY CONTROL
RURAL AREAS
RURAL HOUSEHOLDS
RURAL POPULATION
SAFETY
SOCIAL HEALTH INSURANCE
STANDARD ERRORS
VILLAGES
WORKERS
Online Access:http://documents.worldbank.org/curated/en/2007/03/7410304/extending-health-insurance-rural-population-impact-evaluation-chinas-new-cooperative-medical-scheme
http://hdl.handle.net/10986/7202
Description
Summary:In 2003, after over 20 years of minimal health insurance coverage in rural areas, China launched a heavily subsidized voluntary health insurance program for rural residents. The authors use program and household survey data, as well as health facility census data, to analyze factors affecting enrollment into the program and to estimate its impact on households and health facilities. They obtain estimates by combining differences-in-differences with matching methods. The authors find some evidence of lower enrollment rates among poor households, holding other factors constant, and higher enrollment rates among households with chronically sick members. The household and facility data point to the scheme significantly increasing both outpatient and inpatient utilization (by 20-30 percent), but they find no impact on utilization in the poorest decile. For the sample as a whole, the authors find no statistically significant effects on average out-of-pocket spending, but they do find some-albeit weak-evidence of increased catastrophic health spending. For the poorest decile, by contrast, they find that the scheme increased average out-of-pocket spending but reduced the incidence of catastrophic health spending. They find evidence that the program has increased ownership of expensive equipment among central township health centers but had no impact on cost per case.

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