IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v16y2019i23p4775-d291878.html
   My bibliography  Save this article

Progress on Catastrophic Health Expenditure in China: Evidence from China Family Panel Studies (CFPS) 2010 to 2016

Author

Listed:
  • Xiaochen Ma

    (China Center for Health Development Studies, Peking University, Beijing 100191, China
    These authors contributed equally and are co-first authors.)

  • Ziyue Wang

    (China Center for Health Development Studies, Peking University, Beijing 100191, China
    Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China
    These authors contributed equally and are co-first authors.)

  • Xiaoyun Liu

    (China Center for Health Development Studies, Peking University, Beijing 100191, China)

Abstract

Background: To provide an updated estimate of the level and change in catastrophic health expenditure in China and examine the association between catastrophic health expenditure and family net income, we obtained data from four waves of the China Family Panel Studies conducted between 2010 and 2016. Method: We defined catastrophic health expenditure as out-of-pocket payments equaling or exceeding 40% of the household’s capacity to pay. The Poisson regression with robust variance and generalized estimated equation (Poisson-GEE) model was used to quantify the level and change of catastrophic health expenditure, as well as the association between catastrophic heath expenditure and family net income. Result: Overall, the incidence of catastrophic expenditure in China experienced a 0.70-fold change between 2010 (12.57%) and 2016 (8.94%). The incidence of catastrophic health expenditure (CHE) decreased more in the poorest income quintile than the richest income quintile (annual decrease of 1.17% vs. 0.24% in urban areas, p < 0.001; 1.64% vs. −0.02% in rural areas, p < 0.001). Every 100% increase in income was associated with a 14% relative-risk reduction in CHE (RR = 0.86, 95% CI: 0.85–0.88) after adjusting for demographics, health needs, and health utilization characteristics; this association was weaker in recent years. Conclusion: Our analysis found that China made progress to reduce catastrophic health expenditure, especially for poorer groups. Income growth is strongly associated with this change.

Suggested Citation

  • Xiaochen Ma & Ziyue Wang & Xiaoyun Liu, 2019. "Progress on Catastrophic Health Expenditure in China: Evidence from China Family Panel Studies (CFPS) 2010 to 2016," IJERPH, MDPI, vol. 16(23), pages 1-11, November.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:23:p:4775-:d:291878
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/16/23/4775/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/16/23/4775/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. McIntyre, Diane & Thiede, Michael & Dahlgren, Göran & Whitehead, Margaret, 2006. "What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts?," Social Science & Medicine, Elsevier, vol. 62(4), pages 858-865, February.
    2. Kaushalendra Kumar & Ashish Singh & Santosh Kumar & Faujdar Ram & Abhishek Singh & Usha Ram & Joel Negin & Paul R Kowal, 2015. "Socio-Economic Differentials in Impoverishment Effects of Out-of-Pocket Health Expenditure in China and India: Evidence from WHO SAGE," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-19, August.
    3. Pannarunothai, Supasit & Mills, Anne, 1997. "The poor pay more: Health-related inequality in Thailand," Social Science & Medicine, Elsevier, vol. 44(12), pages 1781-1790, June.
    4. Adam Wagstaff & Eddy van Doorslaer, 2003. "Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993–1998," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 921-933, November.
    5. World Health Organization & World Bank, 2017. "Tracking Universal Health Coverage," World Bank Publications - Books, The World Bank Group, number 29042.
    6. Ye Li & Qunhong Wu & Chaojie Liu & Zheng Kang & Xin Xie & Hui Yin & Mingli Jiao & Guoxiang Liu & Yanhua Hao & Ning Ning, 2014. "Catastrophic Health Expenditure and Rural Household Impoverishment in China: What Role Does the New Cooperative Health Insurance Scheme Play?," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-9, April.
    7. Priyanka Saksena & Justine Hsu & David B Evans, 2014. "Financial Risk Protection and Universal Health Coverage: Evidence and Measurement Challenges," PLOS Medicine, Public Library of Science, vol. 11(9), pages 1-11, September.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Feng Wang & HaiYing Wang & Jun Yan, 2023. "Diagnostic Tests for the Necessity of Weight in Regression With Survey Data," International Statistical Review, International Statistical Institute, vol. 91(1), pages 55-71, April.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Yerramilli, Pooja & Fernández, Óscar & Thomson, Sarah, 2018. "Financial protection in Europe: a systematic review of the literature and mapping of data availability," Health Policy, Elsevier, vol. 122(5), pages 493-508.
    2. Somkotra, Tewarit & Lagrada, Leizel P., 2008. "Payments for health care and its effect on catastrophe and impoverishment: Experience from the transition to Universal Coverage in Thailand," Social Science & Medicine, Elsevier, vol. 67(12), pages 2027-2035, December.
    3. Axel Demenet, 2016. "Health Shocks and Permanent Income Loss: the Household Business Channel," Working Papers DT/2016/11, DIAL (Développement, Institutions et Mondialisation).
    4. Anshul Kastor & Sanjay K Mohanty, 2018. "Disease-specific out-of-pocket and catastrophic health expenditure on hospitalization in India: Do Indian households face distress health financing?," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-18, May.
    5. Jay Dev Dubey, 2021. "Measuring Income Elasticity of Healthcare-Seeking Behavior in India: A Conditional Quantile Regression Approach," Journal of Quantitative Economics, Springer;The Indian Econometric Society (TIES), vol. 19(4), pages 767-793, December.
    6. Johnston, Bridget M. & Burke, Sara & Barry, Sarah & Normand, Charles & Ní Fhallúin, Maebh & Thomas, Steve, 2019. "Private health expenditure in Ireland: Assessing the affordability of private financing of health care," Health Policy, Elsevier, vol. 123(10), pages 963-969.
    7. Haiyan Jia & Xiaoyu Sai & Yangyue Su & Ying Huang, 2022. "Measurement and Decomposition of the Health Poverty of Rural Residents in China," IJERPH, MDPI, vol. 19(19), pages 1-20, October.
    8. Raúl Del Pozo-Rubio & Isabel Pardo-García & Francisco Escribano-Sotos, 2020. "Financial Catastrophism Inherent with Out-of-Pocket Payments in Long Term Care for Households: A Latent Impoverishment," IJERPH, MDPI, vol. 17(1), pages 1-19, January.
    9. Pedrazzoli, Debora & Carter, Daniel J. & Borghi, Josephine & Laokri, Samia & Boccia, Delia & Houben, Rein MGJ., 2021. "Does Ghana's National Health Insurance Scheme provide financial protection to tuberculosis patients and their households?," Social Science & Medicine, Elsevier, vol. 277(C).
    10. Kumar, Kaushalendra & Singh, Abhishek & James, K.S. & McDougal, Lotus & Raj, Anita, 2020. "Gender bias in hospitalization financing from borrowings, selling of assets, contribution from relatives or friends in India," Social Science & Medicine, Elsevier, vol. 260(C).
    11. Arnousse Beaulière & Siaka Touré & Pierre-Kébreau Alexandre & Koko Koné & Alex Pouhé & Bertin Kouadio & Neige Journy & Jérôme Son & Virginie Ettiègne-Traoré & François Dabis & Serge Eholié & Xavier An, 2010. "The Financial Burden of Morbidity in HIV-Infected Adults on Antiretroviral Therapy in Côte d'Ivoire," PLOS ONE, Public Library of Science, vol. 5(6), pages 1-7, June.
    12. Chen, Mingsheng & Xu, Lizheng & Si, Lei & Wang, Zhonghua & Jan, Stephen, 2023. "Examining the level and distribution of catastrophic health expenditure from 2013 to 2018: A province-level study in China," Economic Modelling, Elsevier, vol. 121(C).
    13. Yue Zhou & Haishaerjiang Wushouer & Daniel Vuillermin & Xiaodong Guan & Luwen Shi, 2021. "Does the universal medical insurance system reduce catastrophic health expenditure among middle-aged and elderly households in China? A longitudinal analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(3), pages 463-471, April.
    14. Hsu, Justine & Majdzadeh, Reza & Mills, Anne & Hanson, Kara, 2021. "A dominance approach to analyze the incidence of catastrophic health expenditures in Iran," Social Science & Medicine, Elsevier, vol. 285(C).
    15. Arsenijevic, Jelena & Pavlova, Milena & Groot, Wim, 2013. "Measuring the catastrophic and impoverishing effect of household health care spending in Serbia," Social Science & Medicine, Elsevier, vol. 78(C), pages 17-25.
    16. Chantzaras, Athanasios E. & Yfantopoulos, John N., 2018. "Financial protection of households against health shocks in Greece during the economic crisis," Social Science & Medicine, Elsevier, vol. 211(C), pages 338-351.
    17. Sarah Ssewanyana & Ibrahim Kasirye, 2020. "Estimating Catastrophic Health Expenditures from Household Surveys: Evidence from Living Standard Measurement Surveys (LSMS)-Integrated Surveys on Agriculture (ISA) from Sub-Saharan Africa," Applied Health Economics and Health Policy, Springer, vol. 18(6), pages 781-788, December.
    18. John E. Ataguba, 2021. "Assessing financial protection in health: Does the choice of poverty line matter?," Health Economics, John Wiley & Sons, Ltd., vol. 30(1), pages 186-193, January.
    19. A. Akhtar & Nadeem Ahmad & Indrani Roy Chowdhury, 2020. "Socio-economic inequality in catastrophic health expenditure among households in India: A decomposition analysis," Indian Economic Review, Springer, vol. 55(2), pages 339-369, December.
    20. Cleary, Susan & Birch, Steve & Chimbindi, Natsayi & Silal, Sheetal & McIntyre, Di, 2013. "Investigating the affordability of key health services in South Africa," Social Science & Medicine, Elsevier, vol. 80(C), pages 37-46.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:16:y:2019:i:23:p:4775-:d:291878. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.