IDEAS home Printed from https://ideas.repec.org/a/spr/hecrev/v12y2022i1d10.1186_s13561-022-00365-z.html
   My bibliography  Save this article

The comparison of catastrophic health expenditure and its inequality between urban and rural households in China

Author

Listed:
  • Xian-zhi Fu

    (Wuhan University)

Abstract

Background In recent years, the goal of universal coverage of the basic medical insurance schemes has been basically achieved in China, but the heavy economic burden of diseases is still the main cause of poverty in many households. Exploring catastrophic health expenditure (CHE) and its inequality are highly important for forward-looking policymaking. This study aims to compare the incidence, intensity and inequality of CHE between urban and rural households in China. Methods This study was based on a national representative household survey—the China Family Panel Studies (CFPS)—that was conducted from 2012 to 2018. Concentration index (CI) was employed to measure the inequality of CHE incidence and overshoot, while the decomposition method of the CI was used to estimate the main influencing factors affecting inequality of CHE incidence. Results From 2012 to 2018, the CHE incidence of urban households increased from 11.01 to 11.88%, while the CHE incidence of rural households decreased from 18.42 to 18.31%. During the same period, the CI of CHE incidence for urban households decreased from − 0.1480 to − 0.1693, while that for rural households declined from − 0.1062 to − 0.1501. The major contribution to the pro-poor inequality in CHE incidence was associated with socioeconomic status, lagged CHE, receiving inpatient services, having elderly members, education of household head, and self-assessed health status of household head. Conclusions Rural households had higher risk of incurring CHE than urban households. The strong pro-poor inequality for CHE incidence and overshoot could be found in both two groups. The problem of poverty due to illness was more severe among low-income groups in rural areas than in urban areas. The relevant policy interventions should further focus on encouraging the development of supplementary medical insurance and increasing the reimbursement rate for hospitalization expenses in the medical assistance system.

Suggested Citation

  • Xian-zhi Fu, 2022. "The comparison of catastrophic health expenditure and its inequality between urban and rural households in China," Health Economics Review, Springer, vol. 12(1), pages 1-17, December.
    • Handle: RePEc:spr:hecrev:v:12:y:2022:i:1:d:10.1186_s13561-022-00365-z
    DOI: 10.1186/s13561-022-00365-z
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1186/s13561-022-00365-z
    File Function: Abstract
    Download Restriction: no
    File URL: https://libkey.io/10.1186/s13561-022-00365-z?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Owen O'Donnell & Eddy van Doorslaer & Adam Wagstaff & Magnus Lindelow, 2008. "Analyzing Health Equity Using Household Survey Data : A Guide to Techniques and Their Implementation," World Bank Publications - Books, The World Bank Group, number 6896.
    2. 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.
    3. World Health Organization & World Bank, 2017. "Tracking Universal Health Coverage," World Bank Publications - Books, The World Bank Group, number 29042.
    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. Tomson Ogwang & Germano Mwabu, 2024. "Adaptation of the Foster‐Greer‐Thorbecke poverty measures for the measurement of catastrophic health expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 33(10), pages 2419-2436, October.

    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. Tomson Ogwang & Germano Mwabu, 2024. "Adaptation of the Foster‐Greer‐Thorbecke poverty measures for the measurement of catastrophic health expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 33(10), pages 2419-2436, October.
    2. Richard Mussa, 2016. "Exit from catastrophic health payments: a method and an application to Malawi," International Journal of Health Economics and Management, Springer, vol. 16(2), pages 163-174, June.
    3. Steven F Koch & Naomi Setshegetso, 2020. "Catastrophic health expenditures arising from out-of-pocket payments: Evidence from South African income and expenditure surveys," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-14, August.
    4. Niëns, L.M. & Brouwer, W.B.F., 2013. "Measuring the affordability of medicines: Importance and challenges," Health Policy, Elsevier, vol. 112(1), pages 45-52.
    5. Kaiser, Andrea Hannah & Okorafor, Okore & Ekman, Björn & Chhim, Srean & Yem, Sokunthea & Sundewall, Jesper, 2023. "Assessing progress towards universal health coverage in Cambodia: Evidence using survey data from 2009 to 2019," Social Science & Medicine, Elsevier, vol. 321(C).
    6. Ahmed Shoukry Rashad & Mesbah Fathy Sharaf, 2015. "Catastrophic Economic Consequences of Healthcare Payments: Effects on Poverty Estimates in Egypt, Jordan, and Palestine," Economies, MDPI, vol. 3(4), pages 1-19, November.
    7. Eddy van Doorslaer & Owen O'Donnell, 2008. "Measurement and Explanation of Inequality in Health and Health Care in Low-Income Settings," WIDER Working Paper Series DP2008-04, World Institute for Development Economic Research (UNU-WIDER).
    8. Mohammad Abu-Zaineh & Habiba Romdhane & Bruno Ventelou & Jean-Paul Moatti & Arfa Chokri, 2013. "Appraising financial protection in health: the case of Tunisia," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 73-93, March.
    9. 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).
    10. Mohammad Hajizadeh & Hong Nghiem, 2011. "Out-of-pocket expenditures for hospital care in Iran: who is at risk of incurring catastrophic payments?," International Journal of Health Economics and Management, Springer, vol. 11(4), pages 267-285, December.
    11. Baltica Cabieses & Richard Cookson & Manuel Espinoza & Gillian Santorelli & Iris Delgado, 2015. "Did Socioeconomic Inequality in Self-Reported Health in Chile Fall after the Equity-Based Healthcare Reform of 2005? A Concentration Index Decomposition Analysis," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-21, September.
    12. 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.
    13. Ligane Massamba Séne & Ousmane Badiane, 2016. "Out-of-pocket health payments: a catalyst for agricultural productivity growth, but with potentially impoverishing effects in Senegal," Review of Agricultural, Food and Environmental Studies, Springer, vol. 97(1), pages 29-49, June.
    14. Khurshid Alam & Ajay Mahal, 2016. "The Economic Burden of Road Traffic Injuries on Households in South Asia," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-16, October.
    15. Grigorakis, Nikolaos & Floros, Christos & Tsangari, Haritini & Tsoukatos, Evangelos, 2016. "Out of pocket payments and social health insurance for private hospital care: Evidence from Greece," Health Policy, Elsevier, vol. 120(8), pages 948-959.
    16. Gemini Mtei & Josephine Borghi & Kara Hanson, 2015. "Predicting Consumption Expenditure for the Analysis of Health Care Financing Equity in Low Income Countries: a Comparison of Approaches," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 124(2), pages 339-355, November.
    17. Jeannette Amaya Lara & Fernando Ruiz Gómez, 2011. "Determining factors of catastrophic health spending in Bogota, Colombia," International Journal of Health Economics and Management, Springer, vol. 11(2), pages 83-100, June.
    18. Abdulrahman Jbaily & Annie Haakenstad & Mizan Kiros & Carlos Riumallo-Herl & Stéphane Verguet, 2022. "Examining the density in out-of-pocket spending share in the estimation of catastrophic health expenditures," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(5), pages 903-912, July.
    19. Azam, Mehtabul, 2018. "Does Social Health Insurance Reduce Financial Burden? Panel Data Evidence from India," World Development, Elsevier, vol. 102(C), pages 1-17.
    20. 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.

    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:spr:hecrev:v:12:y:2022:i:1:d:10.1186_s13561-022-00365-z. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com/economics/journal/13561 .

    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.