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National Health Insurance Development in China from 2004 to 2011: Coverage versus Benefits

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Listed:
  • Yan Zhang
  • Wenxi Tang
  • Xiang Zhang
  • Yaoguang Zhang
  • Liang Zhang

Abstract

Background: The simultaneous improvement of the security capability of China Health Insurance System and its development in the last decade remains uncertain. This study measures the status and trends of reimbursement levels of the China Health Insurance System, as well as to offer policy advice to subsequent insurance reforms. Methods: The National Reimbursement Ratio was created to determine the reimbursement level of the national health insurance system based on total health expenditure and the covered population. Chinese total health expenditure data from 2004 to 2011 were extracted from China’s Health Statistics according to the standards of the International Classification for Health Accounts by Healthcare Financing. Results: In 2011, the medical expenditure per capita in China was USD 130.95 and the National Reimbursement Ratio was 26.39%. The National Reimbursement Ratio showed an intense transition from 2004 to 2011, with a sharp decrease from 98.51% in 2004 to 22.44% in 2009, and then a small increase to 26.39% in 2011. Conclusion: The National Reimbursement Ratio was effective in revealing the reimbursement level of the national health insurance system and in predicting its trends. The challenge to China’s healthcare reform is to switch from increasing insurance coverage to guaranteeing a steady increase in government input and building a powerful supervision mechanism.

Suggested Citation

  • Yan Zhang & Wenxi Tang & Xiang Zhang & Yaoguang Zhang & Liang Zhang, 2015. "National Health Insurance Development in China from 2004 to 2011: Coverage versus Benefits," PLOS ONE, Public Library of Science, vol. 10(5), pages 1-10, May.
    • Handle: RePEc:plo:pone00:0124995
    DOI: 10.1371/journal.pone.0124995
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    References listed on IDEAS

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    1. Yinjun Zhao & Bowei Kang & Yawen Liu & Yichong Li & Guoqing Shi & Tao Shen & Yong Jiang & Mei Zhang & Maigeng Zhou & Limin Wang, 2014. "Health Insurance Coverage and Its Impact on Medical Cost: Observations from the Floating Population in China," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-9, November.
    2. Qun Wang & Alex Z Fu & Stephan Brenner & Olivier Kalmus & Hastings Thomas Banda & Manuela De Allegri, 2015. "Out-of-Pocket Expenditure on Chronic Non-Communicable Diseases in Sub-Saharan Africa: The Case of Rural Malawi," PLOS ONE, Public Library of Science, vol. 10(1), pages 1-15, January.
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    Cited by:

    1. Zao Li & Yanyan Gao & Li Yu & Charles L. Choguill & Weiyi Cui, 2022. "Analysis of the Elderly’s Preferences for Choosing Medical Service Facilities from the Perspective of Accessibility: A Case Study of Tertiary General Hospitals in Hefei, China," IJERPH, MDPI, vol. 19(15), pages 1-23, August.
    2. Jiang, Yawen & Ni, Weiyi, 2020. "Impact of supplementary private health insurance on hospitalization and physical examination in China," China Economic Review, Elsevier, vol. 63(C).
    3. Chaw-Yin Myint & Milena Pavlova & Khin-Ni-Ni Thein & Wim Groot, 2019. "A systematic review of the health-financing mechanisms in the Association of Southeast Asian Nations countries and the People’s Republic of China: Lessons for the move towards universal health coverag," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-18, June.
    4. Lingyu Gao & Xiaoli Wang, 2019. "Healthcare Supply Chain Network Coordination Through Medical Insurance Strategies with Reference Price Effect," IJERPH, MDPI, vol. 16(18), pages 1-23, September.

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