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Author: Dan Liu
Publisher: Development Economics and Policy
ISBN: 9783631648551
Category : Cooperative insurance
Languages : en
Pages : 0
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Book Description
The New Cooperative Medical Scheme (NCMS) was implemented in 2003 in response to the poor state of health care in rural China. This study offers a contribution to improve the NCMS design, particularly as to regional policy development, reimbursement arrangements, the efficiency of public investment, and improvements of rural infrastructure.
Author: Dan Liu
Publisher: Development Economics and Policy
ISBN: 9783631648551
Category : Cooperative insurance
Languages : en
Pages : 0
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Book Description
The New Cooperative Medical Scheme (NCMS) was implemented in 2003 in response to the poor state of health care in rural China. This study offers a contribution to improve the NCMS design, particularly as to regional policy development, reimbursement arrangements, the efficiency of public investment, and improvements of rural infrastructure.
Author: Corey Lipow
Publisher: LAP Lambert Academic Publishing
ISBN: 9783838377322
Category :
Languages : en
Pages : 64
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Book Description
Since the first pilot NCMS s in 2003, the New Cooperative Medical Scheme has offered catastrophic illness and other medical coverage to rural residents in China. Yet few studies have examined whether the scheme actually improves health status, utilization of health care services, and the burden of health care expenditures. This study employs non-pooled and pooled Ordinary-Least-Squares regression and linear probability models to further examine this issue. I also include an interaction term between the NCMS and distance from a medical facility to determine whether the effect of the NCMS differs by distance. I find that participating in the NCMS reduces sickness and injury at most distances from a medical facility, and that as distance increases after about 8.6 minutes, so does the negative effect of NCMS participation on sickness or injury. The NCMS appears to increase preventive care utilization but not more formal medical care, and there is mixed indication that the NCMS reduces costs. This study should inform policymakers of the shortcomings of the NCMS as well as anyone else who is interested in the varied effect of insurance based on distance from a medical facility.
Author:
Publisher: World Bank Publications
ISBN:
Category : Child development
Languages : en
Pages : 40
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Book Description
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 data point 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.
Author: Adam Wagstaff
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
China's old rural Cooperative Medical Scheme (CMS) all but collapsed following the economic reforms of the early 1980s. In an effort to reduce financial risk and make health care more affordable, the Government of China recently began piloting of a new voluntary health insurance scheme for rural areas, commonly referred to as the New Cooperative Medical Scheme (NCMS). Using panel data from both households and providers, this paper provides an early assessment of the impact of the NCMS on medical expenditures, prevalence of catastrophic health care expenditures, use of health services, and facility revenues and activities. It shows NCMS enrollment is influenced by income level, health status, and other observable characteristics. Controlling for selection bias using differences-in-differences and matching methods, the paper finds that the scheme has increased utilization of health services. However, it has not reduced out-of-pocket spending or the risk of catastrophic health expenditures. The household level evidence is consistent with findings of increased service volumes and revenues at facility level.
Author: Dan Liu
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
The New Cooperative Medical Scheme (NCMS) program was implemented in response to 'illness-led poverty' and poor state of healthcare in rural China. Supported by government subsidy, more and more poor rural households are now enrolled in the NCMS. This paper investigates the impact of the NCMS program on improving health care utilization and reducing medical expenditure with a specific focus on the endeavors to unravel the heterogeneous effects of the program for the different regions and income groups. We utilize the China Health and Nutrition Survey data (CHNS) to provide prolific cross section and longitudinal information. A total sample of 6,293 individuals and 2,058 households are included in the analysis. Propensity score matching method and bounding approach are used to infer the causal effect of NCMS and examine the influence of unobservable factors respectively. Major findings indicate that there is a systematic adverse selection in the NCMS program, both in health- and economic-related aspects. Especially in western regions, households with high ratio of migrant workers are less attracted to the NCMS program. The NCMS program improved medical care utilization for the poor and regionally, western regions benefitted more from the program. The NCMS program also induces a moral hazard problem in western regions.
Author: Xiaoyun Sun
Publisher:
ISBN:
Category : Medical care
Languages : en
Pages : 422
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Book Description
Author: Xiao Liu
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
In 2003, China launched the New Cooperative Medical Scheme (NCMS), a public healthcare plan targeting rural households. While the literature mostly considers the impact of NCMS coverage on health outcomes, we investigate potential impacts on labor supply and household savings levels. To mitigate endogeneity bias driven by households self-sorting into NCMS coverage, we use panel data spanning two decades to estimate difference-in-differences and instrumental variables (2SLS) models. We find NCMS coverage reduced aggregate labor supply by roughly 8%. Consistent with Borjas (2003), we find the NCMS impacts are larger for higher income households.
Author: Adam Wagstaff
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
In 2003, China launched a heavily subsidized voluntary health insurance program for rural residents. We combine differences-in-differences with matching methods to obtain impact estimates, using data collected from program administrators, health facilities and households. The scheme has increased outpatient and inpatient utilization, and has reduced the cost of deliveries. But it has not reduced out-of-pocket expenses per outpatient visit or inpatient spell. Out-of-pocket payments overall have not been reduced. We find heterogeneity across income groups and implementing counties. The program has increased ownership of expensive equipment among central township health centers but has had no impact on cost per case.
Author: Linxiu Zhang
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Book Description
Few studies have examined the association between the New Cooperative Medical Scheme (NCMS) policy design and its achievement of providing financial protection to rural residents. This study collected data on NCMS policy design and health care spending from 25 counties and rural households in their catchment areas. It shows that on average, NCMS has a growing but small effect on the reduction of catastrophic medical payment (CMP) incidence. If outpatient spending can be reimbursed from an NCMS pooled account, the incidence of CMP before a reimbursement and that after a reimbursement will be reduced. Higher nominal reimbursement rate for inpatient spending at provincial hospitals is correlated with higher incidence of CMP before a reimbursement. Higher ceiling for annual reimbursement from NCMS is associated with lower incidence of CMP after a reimbursement. Thus, NCMS policy design can be improved to strengthen its effects on the reduction of CMP incidence.
Author: Lingguo Cheng
Publisher:
ISBN:
Category :
Languages : en
Pages : 36
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Book Description
This paper investigates the effects of China's New Cooperative Medical Scheme (NCMS) on health outcomes and health care expenditure of the elderly in rural China, using panel data from the 2005 and 2008 waves of the Chinese Longitudinal Healthy Longevity Survey. We employ a strategy that combines propensity score matching with a difference-in-differences approach to address selection bias. We show for the first time in the literature that the NCMS has significantly improved the health status of the elderly enrollees. The beneficial health effects of the NCMS can be attributed to more adequate health care utilization among the insured. However, there is no evidence that the NCMS has reduced their out-of-pocket spending. Furthermore, the effects of the NCMS on elderly health are differentiated by socioeconomic status and by gender. In particular, we consistently find that the NCMS has had a significant positive impact on health outcomes for the elderly at the bottom of the income distribution, or in the relatively poor western region, which suggests that the NCMS helps reduce health inequalities among the rural elderly.
