Abstract
China’s rural older are the threat from chronic diseases, making it important to evaluate the effect of public health insurance on the health care utilization and expenditures with chronic diseases. In 2003, China initiated a public health insurance, which was called the New Rural Cooperative Medical System (NRCMS). NRCMS is a voluntary program, targeting rural residents with government subsidies and individual contribution. Using the two-stage residual inclusion approach (2SRI), we analyzed the impact of NRCMS on health-care service utilization and expenditure of rural older with chronic diseases by using the 2011 and 2013 China Health and Retirement Survey (CHARLS) data. The results showed NRCMS did not play an effective role on improving the medical services utilization of rural older with chronic diseases. Although NRCMS immediate reimbursement significantly reduced the outpatient service fee, the actual outpatient reimbursement is the opposite. In addition, NRCMS did not significantly decrease their hospitalization expense. Policy makers should pay attention to health management about chronic diseases in rural China, and some measures should be taken to deepen the medical security system reform and improve the public health service system.
Highlights
China has transitioned from being one of the fastest-growing populations to among the most rapidly aging countries worldwide [1]
When investigating the influence of New Rural Cooperative Medical System (NRCMS) on the medical service utilization of rural elderly chronic disease patients, this paper focuses on whether they get treated and that whether they get hospitalized
By adopting the data of CHARLS in 2011 and 2013, this research focuses on the influence of NRCMS on the medical service utilization and expenditure of chronic elder in rural China
Summary
China has transitioned from being one of the fastest-growing populations to among the most rapidly aging countries worldwide [1]. Republic of China: Interpretation of China’s Medium-and Long-term Plan for the Prevention and Treatment of Chronic Diseases (2017–2025), chronic non-communicable diseases have caused 86.6% of the total deaths and more than 70% of the total disease burden in China. It has become the main health threat to people, especially the rural elderly population, and their families. In rural China, elderly people have a high demand for health care or medical services They have to reduce the utilization of medical services resulting from the high medical costs.
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