Extending health insurance to the rural population: an impact evaluation of China's new cooperative medical scheme

Adam Wagstaff, Magnus Lindelow, Gao Jun, Xu Ling and Qian Juncheng

No 4150, Policy Research Working Paper Series from The World Bank

Abstract: In 2003, after over 20 years of minimal health insurance coverage in rural areas, China launched a heavily subsidized voluntary health insurance program for rural residents. The authors use program and household survey data, as well as health facility census data, to analyze factors affecting enrollment into the program and to estimate its impact on households and health facilities. They obtain estimates by combining differences-in-differences with matching methods. The authors find some evidence of lower enrollment rates among poor households, holding other factors constant, and higher enrollment rates among households with chronically sick members. The household and facility datapoint to the scheme significantly increasing both outpatient and inpatient utilization (by 20-30 percent), but they find no impact on utilization in the poorest decile. For the sample as a whole, the authors find no statistically significant effects on average out-of-pocket spending, but they do find some-albeit weak-evidence of increased catastrophic health spending. For the poorest decile, by contrast, they find that the scheme increased average out-of-pocket spending but reduced the incidence of catastrophic health spending. They find evidence that the program has increased ownership of expensive equipment among central township health centers but had no impact on cost per case.

Keywords: Health Monitoring&Evaluation; Housing&Human Habitats; Small Area Estimation Poverty Mapping; Regional Rural Development; Health Economics&Finance (search for similar items in EconPapers)
Date: 2007-03-01
New Economics Papers: this item is included in nep-agr, nep-cna, nep-dev, nep-hea, nep-ias and nep-ltv
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (20)

Downloads: (external link)
http://www-wds.worldbank.org/external/default/WDSC ... ered/PDF/wps4150.pdf (application/pdf)

Related works:
Journal Article: Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme (2009)
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:wbk:wbrwps:4150

Access Statistics for this paper

More papers in Policy Research Working Paper Series from The World Bank 1818 H Street, N.W., Washington, DC 20433. Contact information at EDIRC.
Bibliographic data for series maintained by Roula I. Yazigi ().