The effect of NCMS on catastrophic health expenditure and impoverishment from tuberculosis care in China

International Journal for Equity in Health

Research

Shitong Huan¹  Chengchao Zhou²  Qian Long³  Shenglan Tang⁴  Henry Lucas⁵  Qiang Sun⁶  Fei Huang⁷  Jiaying Chen⁸  Li Xiang⁹  Qiang Li^1,10 

[1] Bill & Melinda Gates Foundation Beijing Office, Beijing, China;Department of Social Medicine and Health Service Management, School of Public Health, Shandong University, Jinan, China;Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Shandong University, Jinan, China;Key Laboratory of Health Economic and Policy Research, NHFPC, Shandong University, Wen-hua-xi Road No. 44, 250012, Jinan City, China;Global Health Research Center, Duke Kunshan University, Kunshan, China;Global Health Research Center, Duke Kunshan University, Kunshan, China;Duke Global Health Institute, Duke University, Durham, NC, USA;Institute of Development Studies, Sussex University, Brighton, UK;Key Laboratory of Health Economic and Policy Research, NHFPC, Shandong University, Wen-hua-xi Road No. 44, 250012, Jinan City, China;Center for Health Management and Policy, Shandong University, Jinan, China;National Center for TB Control and Prevention, China CDC, Beijing, China;School of Health Policy and Management, Nanjing Medical University, Nanjing, China;School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, China;School of Public Health, Xi’an Jiaotong University, Xi’an, China;

关键词: NCMS;    Catastrophic health expenditure;    Impoverishment;    Tuberculosis;    China;   

DOI  :  10.1186/s12939-016-0463-0

 received in 2016-06-29, accepted in 2016-10-12,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundHealth expenditure for tuberculosis (TB) care often pushes households into catastrophe and poverty. New Cooperative Medical Scheme (NCMS) aims to protect households from catastrophic health expenditure (CHE) and impoverishment in rural China. This article assesses the effect of NCMS on relieving CHE and impoverishment from TB care in rural China.MethodsThree hundred fourty-seven TB cases are included in the analysis. We analyze the incidence and intensity of CHE and poverty, and assess the protective effect of NCMS by comparing the CHE and impoverishment before and after reimbursement.ResultsAfter out-of-pocket (OOP) payment for TB care, 16.1 % of non-poor fall below poverty line. The NCMS reduces the incidence of CHE and impoverishment by 11.5 % and 7.3 %. After reimbursement, 46.7 % of the households still experience CHE and 35.4 % are below the poverty line. The NCMS relieves the mean gap, mean positive gap, poverty gap and normalized positive gap by 44.5 %, 51.0 %, US$115.8 and 31.6 % respectively.ConclusionsThe NCMS has partial effect on protecting households from CHE and impoverishment from TB care. The limited protection could be enhanced by redesigning benefit coverage to improve the “height” of the NCMS and representing fee-for-service with alternative payment mechanisms.

【 授权许可】

CC BY   
© The Author(s). 2016