Public Medical Insurance and Healthcare Utilization and Expenditures of Older with Chronic Diseases in Rural China: Evidence from NRCMS

Qi Liu, Jin Liu and Shuntian Sui
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Qi Liu: School of International Economics and Trade, Shanghai Lixin University of Accounting and Finance, 995 Shangchuan Road, Shanghai 201209, China
Jin Liu: Research Institute for Agriculture, Farmer and Rural Society in China, Shanghai University of Finance and Economics, 777 Guoding Road, Shanghai 200433, China
Shuntian Sui: Research Institute for Agriculture, Farmer and Rural Society in China, Shanghai University of Finance and Economics, 777 Guoding Road, Shanghai 200433, China

IJERPH, 2020, vol. 17, issue 20, 1-15

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.

Keywords: public health insurance; chronic diseases; health-care utilization; health-care expenditures; older (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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