Zhan Shu1, Yingli Liu1, Minlin Li1, Jian Li2. 1. School of Public Administration, Central China Normal University, Wuhan, Hubei, 430079, China. 2. Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100020, China.
Abstract
BACKGROUND: In 2009, China began to implement new health system reform aimed at reducing the financial burden of patients. This study aimed to compare changes in the utilization of medical services and expenditures in different groups from 2004 to 2015. METHODS: Pooled cross-sectional data from 2004 to 2015 from the China Health and Nutrition Survey Database were used to conduct a segmental linear regression to estimate changes in the medical expenditures of different groups before and after implementation of the reform. RESULTS: During the reform process, the utilization rate of outpatient healthcare, primary health services and hospital health services showed a trend of increasing first and then decreasing slightly. The frequency of residents using inpatient services increased after the reform. The average medical expenditures increased significantly, especially for uninsured and primary health services users. CONCLUSIONS: China's new round of health reform increased the coverage rate of basic medical insurance. Medical insurance has controlled the growth of the average medical expenditures; nevertheless, the average medical expenditures per patient has shown a continuous upward trend. Consequently, both basic medical insurance funds and residents face greater economic burdens and financial risks. Effective methods of controlling the growth of medical expenditures are therefore required.
BACKGROUND: In 2009, China began to implement new health system reform aimed at reducing the financial burden of patients. This study aimed to compare changes in the utilization of medical services and expenditures in different groups from 2004 to 2015. METHODS: Pooled cross-sectional data from 2004 to 2015 from the China Health and Nutrition Survey Database were used to conduct a segmental linear regression to estimate changes in the medical expenditures of different groups before and after implementation of the reform. RESULTS: During the reform process, the utilization rate of outpatient healthcare, primary health services and hospital health services showed a trend of increasing first and then decreasing slightly. The frequency of residents using inpatient services increased after the reform. The average medical expenditures increased significantly, especially for uninsured and primary health services users. CONCLUSIONS: China's new round of health reform increased the coverage rate of basic medical insurance. Medical insurance has controlled the growth of the average medical expenditures; nevertheless, the average medical expenditures per patient has shown a continuous upward trend. Consequently, both basic medical insurance funds and residents face greater economic burdens and financial risks. Effective methods of controlling the growth of medical expenditures are therefore required.