Benefits Associated with China’s Social Health Insurance Schemes: Trend Analysis and Associated Factors Since Health Reform

Wanyue Dong, Anthony B. Zwi, Ruhai Bai, Chi Shen and Jianmin Gao
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Wanyue Dong: School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing 210023, China
Anthony B. Zwi: School of Social Sciences, Faculty of Arts and Social Sciences, The University of New South Wales, Kensington 2052, Australia
Ruhai Bai: School of Public Affairs, Nanjing University of Science and Technology, Nanjing 210094, China
Chi Shen: School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China
Jianmin Gao: School of Public Policy and Administration, Xi’an Jiaotong University, Xi’an 710049, China

IJERPH, 2021, vol. 18, issue 11, 1-14

Abstract: With the deepening of health insurance reform in China, the integration of social health insurance schemes was put on the agenda. This paper aims to illustrate the achievements and the gaps in integration by demonstrating the trends in benefits available from the three social health insurance schemes, as well as the influencing factors. Data were drawn from the three waves of the China Health and Nutrition Survey (2009, 2011, 2015) undertaken since health reforms commenced. ? 2 , Kruskal–Wallis test, and the Two-Part model were employed in the analysis. The overall reimbursement rate of the Urban Employee Basic Medical Insurance (UEBMI) is higher than that of Urban Resident Basic Medical Insurance (URBMI) or the New Rural Cooperative Medical Scheme (NRCMS) ( p < 0.001), but the gap has narrowed since health reform began in 2009. Both the outpatient and inpatient reimbursement amounts have increased through the URBMI and NRCMS. Illness severity, higher institutional level, and inpatient service were associated with significant increases in the amount of reimbursement received across the three survey waves. The health reform improved benefits covered by the URBMI and NRCMS, but gaps with the UEBMI still exist. The government should consider more the release of health benefits and how to lead toward healthcare equity.

Keywords: social health insurance schemes; benefit trends; health reform; China (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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