Vicky Mengqi Qin1, Yuting Zhang2, Kee Seng Chia3, Barbara McPake4, Yang Zhao4, Emily S G Hulse5, Helena Legido-Quigley3, John Tayu Lee4,6. 1. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore. mq.qin@u.nus.edu. 2. Melbourne Institute, Applied Economic & Social Research, Faculty of Business and Economics, University of Melbourne, Melbourne, Victoria, Australia. 3. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore. 4. Nossal Institute for Global Health, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. 5. Centre for Health Policy, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. 6. Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK.
Abstract
OBJECTIVES: This study aims to examine: (1) temporal trends in the percentage of cost-sharing and amount of out-of-pocket expenditure (OOPE) from 2011 to 2015; (2) factors associated with cost-sharing and OOPE; and (3) the relationships between province-level economic development and cost-sharing and OOPE in China. SETTING: A total of 10,316 adults aged ≥45 years from China followed-up from 2011 to 2015 were included in the analysis. We measured two main outcome variables: (1) patient cost sharing, measured by the percentage of OOPE as total healthcare expenditure, and (2) absolute amount of OOPE. RESULTS: Based on self-reported data, we did not find substantial differences in the percentage of cost sharing, but a significant increase in the absolute amount of OOPE among the middle-aged and older Chinese between 2011 and 2015. The percentage of cost-sharing was considerably higher for outpatient than inpatient care, and the majority paid more than 80% of the total cost for prescription drugs. Provinces with higher GDP per capita tend to have lower cost-sharing and a higher OOPE than their counterparts, but the relationship for OOPE became insignificant after adjusting for individual factors. CONCLUSION: Reducing out-of-pocket expenditure and patient cost sharing is required to improve financial protection from illness, especially for those with those with chronic conditions and reside in less developed regions in China. Ongoing monitoring of financial protection using data from various sources is warranted.
OBJECTIVES: This study aims to examine: (1) temporal trends in the percentage of cost-sharing and amount of out-of-pocket expenditure (OOPE) from 2011 to 2015; (2) factors associated with cost-sharing and OOPE; and (3) the relationships between province-level economic development and cost-sharing and OOPE in China. SETTING: A total of 10,316 adults aged ≥45 years from China followed-up from 2011 to 2015 were included in the analysis. We measured two main outcome variables: (1) patient cost sharing, measured by the percentage of OOPE as total healthcare expenditure, and (2) absolute amount of OOPE. RESULTS: Based on self-reported data, we did not find substantial differences in the percentage of cost sharing, but a significant increase in the absolute amount of OOPE among the middle-aged and older Chinese between 2011 and 2015. The percentage of cost-sharing was considerably higher for outpatient than inpatient care, and the majority paid more than 80% of the total cost for prescription drugs. Provinces with higher GDP per capita tend to have lower cost-sharing and a higher OOPE than their counterparts, but the relationship for OOPE became insignificant after adjusting for individual factors. CONCLUSION: Reducing out-of-pocket expenditure and patient cost sharing is required to improve financial protection from illness, especially for those with those with chronic conditions and reside in less developed regions in China. Ongoing monitoring of financial protection using data from various sources is warranted.
Authors: Ye Li; Qunhong Wu; Ling Xu; David Legge; Yanhua Hao; Lijun Gao; Ning Ning; Gang Wan Journal: Bull World Health Organ Date: 2012-06-13 Impact factor: 9.408
Authors: Adam Wagstaff; Gabriela Flores; Justine Hsu; Marc-François Smitz; Kateryna Chepynoga; Leander R Buisman; Kim van Wilgenburg; Patrick Eozenou Journal: Lancet Glob Health Date: 2017-12-13 Impact factor: 26.763