Abstract
Facing difficulties like increasing health burden and health inequity, China government started to promote commercial health insurance (CHI) in recent decades. Several policies and announcement have been issued to build up a favorable environment for development of commercial health insurance. Meanwhile, scholar tried to investigate the related issues in purpose to further improve the situation in China. Therefore, we performed this systematic review in order depict a comprehensive picture on the current evidence-based researches of CHI in China. We searched PubMed, ScienceDirect, and CNKI, supplemented with hand search in reference lists, for eligible studies published from 1990 January to 2018 April. Also, hand search was conducted to select suitable articles from international organization and reference list of eligible articles. Two independent reviewers extracted the data from eligible articles and input into a standardized form. Based on the inclusion criteria, 35 articles were included in this systematic review. Most of the studies were quantitative researches with topics such as the development level of commercial health insurance in China, the demand and supply issues related, and the relationship and influence of social health insurance, as well as the moral issues evolved from commercial health insurance system. In summary, CHI in China is still at the early development stage. Among those few evidence-based articles, the findings suggested several policy implication and different market strategy. With the initiation of new health reforms and implementation of taxes policy, more empirical researches should be conducted on issues relating to the practical operation of CHI.
Highlights
Since last century, with changes in socioeconomic structures, demand on healthcare services and healthcare expenditure level has dramatically arisen
Regarding the objective and measurement of the studies, the result is categorized into several groups, including issues related to demand and supply, development level of commercial health insurance, health financial protection functioning, social health insurance, and other issues
Out of the 35 reviewed papers, around one-fifth were reported in English while the rest were written in Chinese, in the period from 2007 to 2018
Summary
With changes in socioeconomic structures, demand on healthcare services and healthcare expenditure level has dramatically arisen. It is believed that the continuous increasing trend on total health expenditure would be unchanged in near future Another problem is the unequal accessibility and service utilization of health services between rural and urban and between the rich and the poor [4]. There are three main schemes covering different population in rural and urban separately, including Urban Employee Basic Medical Insurance (UEBMI, launched in 1998), New Cooperative Medical Scheme (NCMS, launched in 2003), and Urban Resident Basic Medical Insurance (URBMI, launched in 2007) [5,6,7] These schemes aim to provide universal coverage of health services and alleviate the unbalanced accessibility of medical services between different social classes. The role of commercial health insurance (CHI) becomes more important
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