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Improvement of the reduction in catastrophic health expenditure in China’s public health insurance

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  • Dengfeng Wu
  • Fang Yu
  • Wei Nie

Abstract

This study aimed to locate the contributing factors of Catastrophic Health Expenditure (CHE), evaluate their impacts, and try to propose strategies for reducing the possibilities of CHE in the context of China’s current public health insurance system. The financial data of all hospitalization cases from a sample hospital in 2013 were gathered and used to determine the pattern of household medical costs. A simulation model was constructed based on China’s current public health insurance system to evaluate the financial burden for medical service on Chinese patients, as well as to calculate the possibilities of CHE. Then, by adjusting several parameters, suggestions were made for China’s health insurance system in order to reduce CHE. It’s found with China’s current public health insurance system, the financial aid that a patient may receive depends on whether he is from an urban or rural area and whether he is employed. Due to the different insurance policies and the wide income gap between urban and rural areas, rural residents are much more financially vulnerable during health crisis. The possibility of CHE can be more than 50% for low-income rural families. The CHE ratio can be dramatically lowered by applying different policies for different household income groups. It’s concluded the financial burden for medical services of Chinese patients is quite large currently, especially for those from rural areas. By referencing different healthcare policies in the world, applying different health insurance policies for different income groups can dramatically reduce the possibility of CHE in China.

Suggested Citation

  • Dengfeng Wu & Fang Yu & Wei Nie, 2018. "Improvement of the reduction in catastrophic health expenditure in China’s public health insurance," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-21, April.
  • Handle: RePEc:plo:pone00:0194915
    DOI: 10.1371/journal.pone.0194915
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    1. Majumder, Amita & Chakravarty, Satya Ranjan, 1990. "Distribution of Personal Income: Development of a New Model and Its Application to U.S. Income Data," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 5(2), pages 189-196, April-Jun.
    2. McDonald, James B. & Xu, Yexiao J., 1995. "A generalization of the beta distribution with applications," Journal of Econometrics, Elsevier, vol. 69(2), pages 427-428, October.
    3. Guy Carrin, 2002. "Social health insurance in developing countries: A continuing challenge," International Social Security Review, John Wiley & Sons, vol. 55(2), pages 57-69.
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    Cited by:

    1. Pan, Yan & Zhong, Wen-fang & Yin, Rong & Zheng, Meng & Xie, Kun & Cheng, Shu-yuan & Ling, Li & Chen, Wen, 2022. "Does direct settlement of intra-province medical reimbursements improve financial protection among middle-aged and elderly population in China? Evidence based on CHARLS data," Social Science & Medicine, Elsevier, vol. 308(C).
    2. Guangsheng Wan & Zixuan Peng & Yufeng Shi & Peter C. Coyte, 2020. "What Are the Determinants of the Decision to Purchase Private Health Insurance in China?," IJERPH, MDPI, vol. 17(15), pages 1-15, July.

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