Health reform and out-of-pocket payments
Lessons from China
Bibliographic Data
| ID | 11492014 |
|---|---|
| Authors | Lei Zhang (0000-0003-4889-6486, Shanghai International Studies University, corresponding author), Nan Liu (0009-0003-4309-5513, New York University Shanghai) |
| Year | 2014 |
| Volume | 29 |
| Issue | 2 |
| Pages | 217-226 |
| Publication date | 2014-03-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Health Policy and Planning (JOURNAL) |
| Journal identifiers | ISSN: 0268-1080 • E-ISSN: 1460-2237 |
| Publisher | Oxford University Press (PUBLISHER • GB) |
| DOI | 10.1093/heapol/czt006 |
| PMID | 23428367 |
| OpenAlex | W2108705440 |
| Language | EN |
| Citations received | 11 |
| References cited | 9 |
OBJECTIVE: China's ongoing new health reform aims to reduce individual out-of-pocket (OOP) payments for healthcare services. The aim of this article is to analyse the impact of this reform and to draw policy implications. METHODS: Data are retrieved from the relevant government publications. Polynomial regression models are used to predict future health expenditures. An extensive sensitivity analysis is conducted to investigate the ratios of OOP payments to the total health expenditures (THEs) and to the disposable personal income (DPI) for 2009-11 under different scenarios of cost projections and personal income distributions. Both quantitative and qualitative analyses are carried out to draw conclusions. RESULTS: The ratios of OOP payments to THE and DPI vary significantly across scenarios tested. Only if all committed government investments and social health expenditure are realized can China's new health reform reduce both ratios and achieve its target goals. In particular, the ratio of OOP payments to DPI can also be significantly reduced by improving income distribution. Due to the complicated interplay among different cost components in health expenditures, these two ratios may not change in the same direction, indicating that both need to be examined when evaluating the reform. CONCLUSION: The new health reform in China aims to alleviate the high OOP payments for healthcare services, but it has not yet been able to reduce both OOP-to-THE and OOP-to-DPI ratios simultaneously. Major reasons include (1) inability of local governments to fulfil their responsible investments due to health finance decentralization and uneven economic development in China and (2) a serious cost inflation in health expenditures coupled with a low level of income distribution. It is suggested that the central government should bear more financial responsibility and assist local governments to fully invest, and should improve individual incomes, in particular for the poor.
Business · China · Decentralization · Direct Payments · Distribution (mathematics) · Economic growth · Economics · Government (linguistics) · Health care · Health care reform · Payment · Political science · Public economics · Transfer payment · China's Socioeconomic Reforms and Governance · Finance · Healthcare Policy and Management · Healthcare Systems and Reforms · Health Policy
Social Protection under Authoritarianism
Ranking the Healthcare Resource Factors for Public Satisfaction with Health System in China—Based on the Grey Relational Analysis Models
Do poor people in the poorer states pay more for healthcare in India
An interim interdisciplinary evaluation of China’s national health care reform
Economic crisis of rural patients insured with critical illness insurance
Health care utilization and affordability among older people following China’s 2009 health reform -- evidence from CHARLS pilot study
Changes in inequality in utilization of preventive care services
Combating substandard and falsified medicines in China
The impacts of long-term care insurance on health care utilization and expenditure
Years of China's comprehensive health reform
Impact of the Essential Public Health Service program on financial protection and health outcomes among hypertensive patients
| Unique citing works | 11 |
|---|---|
| Citations per year | 1 |
| Citation span | 2015 - 2025 (11) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 11 |