health insurance benefit design and healthcare utilization in northern rural china健康保险福利设计和医疗利用在中国北方农村.pdfVIP

Health Insurance Benefit Design and Healthcare Utilization in Northern Rural China 1,2 1 3 3 1 1 1 Hong Wang *, Yu Liu , Yan Zhu , Lei Xue , Martha Dale , Heather Sipsma , Elizabeth Bradley 1 Department of Health Policy and Administration, School of Public Health, Yale University, New Haven, Connecticut, United States of America, 2 Bill Melinda Gates Foundation, Seattle, Washington, United States of America, 3 Research Center for Healthcare Management, Tsinghua University, Beijing, China Abstract Background: Poverty due to illness has become a substantial social problem in rural China since the collapse of the rural Cooperative Medical System in the early 1980s. Although the Chinese government introduced the New Rural Cooperative Medical Schemes (NRCMS) in 2003, the associations between different health insurance benefit package designs and healthcare utilization remain largely unknown. Accordingly, we sought to examine the impact of health insurance benefit design on health care utilization. Methods and Findings: We conducted a cross-sectional study using data from a household survey of 15,698 members of 4,209 randomly-selected households in 7 provinces, which were representative of the provinces along the north side of the Yellow River. Interviews were conducted face-to-face and in Mandarin. Our analytic sample included 9,762 respondents from 2,642 households. In each household, respondents indicated the type of health insurance benefit that the household had (coverage for inpatient care only or coverage for both inpatient and outpatient care) and the number of outpatient visits in the 30 days preceding the interview and the number of hospitalizations in the 365 days preceding the household interview.