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The inequality of inpatient care net benefit under integration of urban-rural medical insurance systems in China

BACKGROUND: China has recently made efforts to integrate urban and rural basic medical insurance systems in order to ensure both urban and rural enrollees obtain unified benefits. However, whether the distribution of government healthcare subsides has become more equitable remains unknown. The purpo...

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Autores principales: Yang, Xue, Chen, Mingsheng, Du, Jinglin, Wang, Zhonghua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6251195/
https://www.ncbi.nlm.nih.gov/pubmed/30466451
http://dx.doi.org/10.1186/s12939-018-0891-0
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author Yang, Xue
Chen, Mingsheng
Du, Jinglin
Wang, Zhonghua
author_facet Yang, Xue
Chen, Mingsheng
Du, Jinglin
Wang, Zhonghua
author_sort Yang, Xue
collection PubMed
description BACKGROUND: China has recently made efforts to integrate urban and rural basic medical insurance systems in order to ensure both urban and rural enrollees obtain unified benefits. However, whether the distribution of government healthcare subsides has become more equitable remains unknown. The purpose of this study was to analyze determinants of and inequality in net inpatient care benefits under the integration of urban-rural medical insurance systems in China. METHODS: Data were obtained from a nationally representative household survey, the Fifth National Health Services Survey (2013), conducted in Anhui province. A multiple regression model and concentration index (CI) was used to estimate related factors and inequality of inpatient care net benefits. RESULTS: Findings indicated that individuals received more inpatient care benefits when urban and rural social healthcare systems were integrated. Factors associated with net benefits included gender, age, marital status, retirement, educational level, history of chronic diseases, health status, willingness to seek inpatient care and per capita income. The rich were found to disproportionately benefit from inpatient care, and the CI of net benefits for integrated insurance enrollees was the lowest among all three available health insurance schemes. These findings indicate that the recent unification of urban-rural social health insurances reduces inequality in net benefits from government subsidies. Some socioeconomic factors, such as per capita income, 60 years of age and over, history of chronic disease and high educational level positively influence inequality. CONCLUSION: In China, accelerating the integration of urban and rural medical insurance systems is an effective way to increase equity of benefit in urban and rural areas. Strategies aimed at reducing inpatient benefit inequality must address socioeconomic factors influencing healthcare outcomes.
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spelling pubmed-62511952018-11-29 The inequality of inpatient care net benefit under integration of urban-rural medical insurance systems in China Yang, Xue Chen, Mingsheng Du, Jinglin Wang, Zhonghua Int J Equity Health Research BACKGROUND: China has recently made efforts to integrate urban and rural basic medical insurance systems in order to ensure both urban and rural enrollees obtain unified benefits. However, whether the distribution of government healthcare subsides has become more equitable remains unknown. The purpose of this study was to analyze determinants of and inequality in net inpatient care benefits under the integration of urban-rural medical insurance systems in China. METHODS: Data were obtained from a nationally representative household survey, the Fifth National Health Services Survey (2013), conducted in Anhui province. A multiple regression model and concentration index (CI) was used to estimate related factors and inequality of inpatient care net benefits. RESULTS: Findings indicated that individuals received more inpatient care benefits when urban and rural social healthcare systems were integrated. Factors associated with net benefits included gender, age, marital status, retirement, educational level, history of chronic diseases, health status, willingness to seek inpatient care and per capita income. The rich were found to disproportionately benefit from inpatient care, and the CI of net benefits for integrated insurance enrollees was the lowest among all three available health insurance schemes. These findings indicate that the recent unification of urban-rural social health insurances reduces inequality in net benefits from government subsidies. Some socioeconomic factors, such as per capita income, 60 years of age and over, history of chronic disease and high educational level positively influence inequality. CONCLUSION: In China, accelerating the integration of urban and rural medical insurance systems is an effective way to increase equity of benefit in urban and rural areas. Strategies aimed at reducing inpatient benefit inequality must address socioeconomic factors influencing healthcare outcomes. BioMed Central 2018-11-22 /pmc/articles/PMC6251195/ /pubmed/30466451 http://dx.doi.org/10.1186/s12939-018-0891-0 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Yang, Xue
Chen, Mingsheng
Du, Jinglin
Wang, Zhonghua
The inequality of inpatient care net benefit under integration of urban-rural medical insurance systems in China
title The inequality of inpatient care net benefit under integration of urban-rural medical insurance systems in China
title_full The inequality of inpatient care net benefit under integration of urban-rural medical insurance systems in China
title_fullStr The inequality of inpatient care net benefit under integration of urban-rural medical insurance systems in China
title_full_unstemmed The inequality of inpatient care net benefit under integration of urban-rural medical insurance systems in China
title_short The inequality of inpatient care net benefit under integration of urban-rural medical insurance systems in China
title_sort inequality of inpatient care net benefit under integration of urban-rural medical insurance systems in china
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6251195/
https://www.ncbi.nlm.nih.gov/pubmed/30466451
http://dx.doi.org/10.1186/s12939-018-0891-0
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