Abstract
BackgroundTo explore the equity in health services in the rural areas, by studying the rural residents in two counties of Ningbo City, Zhejiang.MethodsMulti-stage stratified cluster random sampling method was performed to draw the study sample. Trained investigators conducted face to face interviews using a questionnaire. Rural residents were stratified into 5 income groups. Centralized index (CI) and risk ratios (RR) were used to assess the equity in health services and the impact of the New Cooperative Medical Scheme (NCMS).ResultsThe centralized index of the 2 weeks prevalence, two-week visiting rate and chronic disease prevalence among different income groups was − 0.0264, − 0.0076 and − 0.0160, respectively, while that of the hospitalization rate was 0.0006. The highest NCMS coverage rate, adjusted risk of disease and catastrophic health expenditure (CHE) rates were observed in lowest income groups (92.86, 4.94 and 32.21%, respectively. Two-week prevalence, chronic diseases prevalence and RR showed a declining trend with increasing income levels.ConclusionNCMS has improved the service availability and reduced the economic burden of diseases. However, its impact on reducing the economic risk of illness and promoting equity in health services has not been significant.
Highlights
To explore the equity in health services in the rural areas, by studying the rural residents in two counties of Ningbo City, Zhejiang
Social health insurance generally refers to health insurance schemes provided by governments for its citizens, especially for the low and middle-income populations
The sampling methodology is consistent with that used in the Chinese fourth national health services survey, and is the standard used for the World Bank-funded projects, for example, for evaluation of basic health services in rural areas and the new cooperative medical scheme evaluation
Summary
To explore the equity in health services in the rural areas, by studying the rural residents in two counties of Ningbo City, Zhejiang. Social health insurance generally refers to health insurance schemes provided by governments for its citizens, especially for the low and middle-income populations. The mechanisms may vary from single-payer government systems to mixed models comprising a variety of financing mechanisms. The basic medical insurance systems in China comprise of Urban Employee Basic Medical Insurance, Urban Residents Basic Medical Insurance, The New Cooperative Medical Scheme (NCMS) and Medical assistance system, which. The NCMS is a Chinese government-led health insurance scheme that aims to make medical insurance more affordable for the rural peasantry. The scheme was launched in the year 2003 and has improved the access to medical insurance among its target population
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