Abstract

IntroductionThe huge number of rural elders and the deepening health problems (e.g. growing threats of infectious diseases and chronic diseases etc.) place enormous pressure on old age health security in rural China. This study aims to provide information for policy-makers to develop effective measures for promoting rural elders’ health care service access by examining the current developments and challenges confronted by the old age health security in rural China.MethodsSearch resources are electronic databases, web pages of the National Bureau of Statistics of China and the National Health and Family Planning Commission of China on the internet, China Population and Employment Statistics Yearbook, China Civil Affairs’ Statistical Yearbook and China Health Statistics Yearbooks etc. Articles were identified from Elsevier, Wiley, EBSCO, EMBASE, PubMed, SCI Expanded, ProQuest, and National Knowledge Infrastructure of China (CNKI) which is the most informative database in Chinese. Search terms were “rural”, “China”, “health security”, “cooperative medical scheme”, “social medical assistance”, “medical insurance” or “community based medical insurance”, “old”, or “elder”, “elderly”, or “aged”, “aging”. Google scholar was searched with the same combination of keywords.ResultsThe results showed that old age health security in rural China had expanded to all rural elders and substantially improved health care service utilization among rural elders. Increasing chronic disease prevalence rates, pressing public health issues, inefficient rural health care service provision system and lack of sufficient financing challenged the old age health security in rural China.ConclusionsIncreasing funds from the central and regional governments for old age health security in rural China will contribute to reducing urban–rural disparities in provision of old age health security and increasing health equity among rural elders between different regions. Meanwhile, initiating provider payment reform may contribute to improving the efficiency of rural health care service provision system and promoting health care service access among rural elders.

Highlights

  • IntroductionThe huge number of rural elders and the deepening health problems (e.g. growing threats of infectious diseases and chronic diseases etc.) place enormous pressure on old age health security in rural China

  • The huge number of rural elders and the deepening health problems place enormous pressure on old age health security in rural China

  • This study aims to provide information for policy-makers to develop effective measures for promoting rural elders’ health care service access by examining the current developments and challenges confronted by the old age health security in rural China

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Summary

Introduction

The huge number of rural elders and the deepening health problems (e.g. growing threats of infectious diseases and chronic diseases etc.) place enormous pressure on old age health security in rural China. By the end of 2014, the number of elders (aged 65 years old and above) had reached 138 million in China, accounting for 10.1 % of the total population [1]. It was estimated that the number of elders may increase to 450 million (nearly one third of the total population) by 2050 [2]. The huge number of rural elders places enormous pressure on old age health security in rural China [5]. The old age health security in rural China, which aims to promote rural elders’ health status and prevent poverty caused by illness, includes social health insurance scheme (new cooperative medical scheme, NCMS) and social medical assistance scheme. In 2003, the Ministry of Health of the People’s Republic of China launched NCMS in rural areas, and the Ministry of Civil Affairs of the People’s Republic of China launched social medical assistance

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