期刊论文详细信息
Frontiers in Public Health
Minimizing the Risk of Catastrophic Health Expenditure in China: A Multi-Dimensional Analysis of Vulnerable Groups
Huan Liu2  Nan Meng2  Daniel Adjei Amporfro2  Ye Li2  Bykov Ilia2  Xin Zhang2  Qunhong Wu2  Xinye Qi2  Zheng Kang2  Linghan Shan2  Shengchao Jiang2  Qiao Xu2  Jiahui Wang2  Peiwen Chen2  Kexin Wang2  Xiao Tan3 
[1] Centre of Health Policy and Management, Health Management College, Harbin Medical University, Harbin, China;Department of Social Medicine, School of Public Health, Health Management College, Harbin Medical University, Harbin, China;Shenzhen Hospital of Guangzhou University of Traditional Chinese Medicine (Futian), Shenzhen, China;
关键词: catastrophic health expenditure;    financial protection;    universal health coverage;    China;    insurance;   
DOI  :  10.3389/fpubh.2021.689809
来源: DOAJ
【 摘 要 】

Background: In moving toward universal health coverage in China, it is crucial to identify which populations should be prioritized for which interventions rather than blindly increasing welfare packages or capital investments. We identify the characteristics of vulnerable groups from multiple perspectives through estimating catastrophic health expenditure (CHE) and recommend intervention priorities.Methods: Data were from National Health Service Survey conducted in 2003, 2008, and 2013. According to the recommendation of WHO, this study adopted 40% as the CHE threshold. A binary regression was used to identify the determinants of CHE occurrence; a probit model was used to obtain CHE standardized incidence under the characteristics of single and two dimensions in 2013.Results: The total incidence of CHE in 2013 was 13.9%, which shows a general trend of growth from 2003 to 2013. Families in western and central regions and rural areas were more at risk. Factors related to social demography show that households with a female or an unmarried head of household or with a low socioeconomic status were more likely to experience CHE. Households with older adults aged 60 and above had 1,524 times higher likelihood of experiencing CHE. Among the health insurance schemes, the participants covered by the New Rural Cooperative Medical Scheme had the highest risk compared with the participants of all basic health insurance schemes. Households with several members seeking outpatient, inpatient care or with non-communicable diseases were more likely to experience CHE. Households with members not seeing a doctor or hospitalized despite the need for it were more likely to experience CHE. Characteristics such as a household head with characteristics related to low socioeconomic status, having more than two hospitalized family members, ranked high. Meanwhile, the combination of having illiterate household heads and with being covered by other health insurance plans or by none ranked the first place. Cancer notably caused a relatively high medical expenditure among households with CHE.Conclusion: In China, considering the vulnerability of the population across different dimensions is conducive to the alleviation of high CHE. Furthermore, people with multiple vulnerabilities should be prioritized for intervention. Identifying and targeting them to offer help and support will be an effective approach.

【 授权许可】

Unknown   

  文献评价指标  
  下载次数:0次 浏览次数:0次