Measuring financial protection for health in families with chronic conditions in Rural China

BMC Public Health

Wujin Luo¹  Xiang Zhang¹  Jingdong Ma¹  Chunhong Jiang¹ 

[1] School of Medicine and Health Management, Huazhong University of Science and Technology, Hang Kong Road, Wuhan, China

关键词: China;    Poverty;    Rural areas;    Chronic disease;    Financial protection;   

Others  :  1162827
DOI  :  10.1186/1471-2458-12-988

 received in 2012-07-03, accepted in 2012-11-12,  发布年份 2012

【 摘 要 】

Background

As the world’s largest developing country, China has entered into the epidemiological phase characterized by high life expectancy and high morbidity and mortality from chronic diseases. Cardiovascular diseases, chronic obstructive pulmonary diseases, and malignant tumors have become the leading causes of death since the 1990s. Constant payments for maintaining the health status of a family member who has chronic diseases could exhaust household resources, undermining fiscal support for other necessities and eventually resulting in poverty. The purpose of this study is to probe to what degree health expenditure for chronic diseases can impoverish rural families and whether the New Cooperative Medical Scheme can effectively protect families with chronic patients against catastrophic health expenditures.

Methods

We used data from the 4^th National Health Services Survey conducted in July 2008 in China. The rural sample we included in the analysis comprised 39,054 households. We used both households suffering from medical impoverishment and households with catastrophic health expenditures to compare the financial protection for families having a chronic patient with different insurance coverage statuses. We used a logistic regression model to estimate the impact of different benefit packages on health financial protection for families having a chronic patient.

Results

An additional 10.53% of the families with a chronic patient were impoverished because of healthcare expenditure, which is more than twice the proportion in families without a chronic patient. There is a higher catastrophic health expenditure incidence in the families with a chronic patient. The results of logistic regression show that simply adding extra benefits did not reduce the financial risks.

Conclusions

There is a lack of effective financial protection for healthcare expenditures for families with a chronic patient in rural China, even though there is a high coverage rate with the New Cooperative Medical Schemes. Given the coming universal coverage by the New Cooperative Medical Scheme and the increasing central government funds in the risk pool, effective financial protection for families should be possible through systematic reform of both financing mechanisms and payment methods.

【 授权许可】

   
2012 Jiang et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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