Meiyan Ma1, Ye Li2, Nianshi Wang1, Qunhong Wu1, Linghan Shan1, Mingli Jiao1, Xuelian Fu3, Heng Li4, Tao Sun5, Bin Yi6, Wanxin Tian1, Qi Xia1, Baoguo Shi7, Yanhua Hao1, Hui Yin1, Ning Ning1, Lijun Gao1, Libo Liang1, Jiahui Wang1. 1. Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, 150086, Heilongjiang, China. 2. Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, 150086, Heilongjiang, China. liye8459@163.com. 3. The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China. 4. China Hospital Development institute of Shanghai Jiao Tong University, Shanghai, China. 5. Department of Health Service Management, School of Medicine, Hang Zhou Normal University, Zhejiang, China. 6. The First Specialized Hospital of Harbin, Harbin, Heilongjiang, China. 7. Department of Economics, School of Economics, Minzu University of China, Beijing, China.
Abstract
BACKGROUND: We examined the physiological, household, and spatial agglomeration characteristics of the health poverty population in China. We identified weak links that affect the implementation of the medical insurance and further improve its effectiveness for health poverty alleviation. METHODS: A national representative sample from the China Health and Retirement Longitudinal Study (CHARLS) was analyzed. The WHO recommended method was adopted to calculate catastrophic health expenditure (CHE) and impoverishment by medical expenses (IME). We created a binary indicator for IME as the outcome variable and applied the treatment-effect model to analyze the determinants of IME. RESULTS: The incidence of IME was 7.2% of the overall population, compared to 20.3% of the sample households trapped in CHE. The incidence of IME enrolled in insurance schemes was 7.4% higher than that of uninsured families (4.8%). Economic level, living area, family size, age of household head, having hospitalized members, and participating in insurance were statistically significant for the occurrence of IME. CONCLUSIONS: The original poverty-promoting policies has not reached the maximum point of convergence with China's current demand for health. The overlapped health vulnerabilities exacerbated the risk of poverty among the elderly and households with high health needs and utilization. In addition, the medical insurance schemes have proven to be insufficient for protection against economic burden of poor households. So, special health needs, age, and household capacity to pay should be comprehensively considered while strengthening the connection between the disease insurance scheme with supplementary insurance.
BACKGROUND: We examined the physiological, household, and spatial agglomeration characteristics of the health poverty population in China. We identified weak links that affect the implementation of the medical insurance and further improve its effectiveness for health poverty alleviation. METHODS: A national representative sample from the China Health and Retirement Longitudinal Study (CHARLS) was analyzed. The WHO recommended method was adopted to calculate catastrophic health expenditure (CHE) and impoverishment by medical expenses (IME). We created a binary indicator for IME as the outcome variable and applied the treatment-effect model to analyze the determinants of IME. RESULTS: The incidence of IME was 7.2% of the overall population, compared to 20.3% of the sample households trapped in CHE. The incidence of IME enrolled in insurance schemes was 7.4% higher than that of uninsured families (4.8%). Economic level, living area, family size, age of household head, having hospitalized members, and participating in insurance were statistically significant for the occurrence of IME. CONCLUSIONS: The original poverty-promoting policies has not reached the maximum point of convergence with China's current demand for health. The overlapped health vulnerabilities exacerbated the risk of poverty among the elderly and households with high health needs and utilization. In addition, the medical insurance schemes have proven to be insufficient for protection against economic burden of poor households. So, special health needs, age, and household capacity to pay should be comprehensively considered while strengthening the connection between the disease insurance scheme with supplementary insurance.
Entities:
Keywords:
Catastrophic health expenditure; Healthy poverty; Impoverishment by medical expenses; Medical insurance; Poverty alleviation
Authors: Sha Chen; Zhiye Lin; Xiaoru Fan; Jushuang Li; Yao-Jie Xie; Chun Hao Journal: Int J Environ Res Public Health Date: 2022-05-13 Impact factor: 4.614
Authors: Jingjing Zhou; Yaoyu Zhang; Yong Sha; Jianfang Zhou; Hang Ren; Xin Shen; Hui Xu Journal: Int J Environ Res Public Health Date: 2022-10-10 Impact factor: 4.614