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International Journal for Equity in Health

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Open Access 01-12-2020 | Research

Targeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the middle age and elderly population?

Authors: Nianshi Wang, Jing Xu, Meiyan Ma, Linghan Shan, Mingli Jiao, Qi Xia, Wanxin Tian, Xiyu Zhang, Limin Liu, Yanhua Hao, Lijun Gao, Qunhong Wu, Ye Li

Published in: International Journal for Equity in Health | Issue 1/2020

Abstract

Background

In light of the health poverty alleviation policy, we explore whether the New Rural Cooperative Medical System (NRCMS) has effectively reduced the economic burden of medical expenses on rural middle-aged and elderly people and other impoverished vulnerable groups. The study aims to provide evidence that can be used to improve the medical insurance system.

Methods

Data were obtained from the 2015 China Health and Retirement Longitudinal Study (CHARLS). The method of calculating the catastrophic health expenditure (CHE) and impoverishment by medical expense (IME) was adopted from the World Health Organization (WHO). The treatment effect model was used to identify the determinants of CHE for rural middle-aged and elderly people.

Results

The incidence of CHE in rural China for middle-aged and elderly people is 21.8%, and the IME is 8.0%. The households that had enrolled in the NRCMS suffered higher CHE (21.9%) and IME (8.0%), than those that had not enrolled (CHE: 20.6% and IME: 7.7%). The NRCMS did not provide sufficient economic protection from CHE for households with three or more chronic diseases, inpatients, or households with members aged over 65 years. Key risk factors for the CHE included education levels, households with inpatients, households with members aged over 65 years, and households with disabilities.

Conclusions

Although the NRCMS has reduced barriers to the usage of household health services by reducing people’s out-of-pocket payments, it has not effectively reduced the risk of these households falling into poverty. Our research identifies the characteristics of vulnerable groups that the NRCMS does not provide enough support for, and which puts them at a greater risk of falling into poverty due to health impoverishment.

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Title: Targeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the middle age and elderly population?
Authors: Nianshi Wang
Jing Xu
Meiyan Ma
Linghan Shan
Mingli Jiao
Qi Xia
Wanxin Tian
Xiyu Zhang
Limin Liu
Yanhua Hao
Lijun Gao
Qunhong Wu
Ye Li
Publication date: 01-12-2020
Publisher: BioMed Central
Published in: International Journal for Equity in Health / Issue 1/2020
Electronic ISSN: 1475-9276
DOI: https://doi.org/10.1186/s12939-020-01236-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Targeting vulnerable groups of health poverty alleviation in rural China— what is the role of the New Rural Cooperative Medical Scheme for the middle age and elderly population?

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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