THE NEW COOPERATIVE MEDICAL SCHEME IN RURAL CHINA: DOES MORE COVERAGE MEAN MORE SERVICE AND BETTER HEALTH?
THE NEW COOPERATIVE MEDICAL SCHEME IN RURAL CHINA: DOES MORE COVERAGE MEAN MORE SERVICE AND BETTER HEALTH?
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DOI：
10.1002/hec.1501
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发表时间：
2009-07-01
期刊：
影响因子：
2.1
通讯作者：
Lin, Wanchuan
中科院分区：
文献类型：
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作者：
Lei, Xiaoyan;Lin, Wanchuan
本文探讨了新型农村合作医疗（NCMS）的影响，一个新的公共医疗保险计划在中国农村。利用中国健康与营养调查（CHNS）的纵向样本，我们采用多重估计策略（个体固定效应模型、工具变量估计和倾向评分匹配的差异中差异估计）来校正潜在的选择偏倚。我们发现，参加新型农村合作医疗显着减少了传统的中国民间医生的使用，并增加了预防保健的利用，特别是一般的身体检查。然而，我们并没有发现，新型农村合作医疗降低了自付支出，也没有发现它增加了正规医疗服务的利用或改善健康状况，如测量的自我报告的健康状况和疾病或伤害在过去的四周。研究表明，尽管新型农村合作医疗的覆盖范围得到了广泛的扩大，但其影响仍然有限。版权所有（C）2009约翰威利父子有限公司
This paper explores the impact of the New Cooperative Medical Scheme (NCMS), a newly adopted public health insurance program in rural China. Using a longitudinal sample drawn from the China Health and Nutrition Survey (CHNS), we employed Multiple estimation strategies (individual fixed-effect models, instrumental variable estimation, and difference-in-differences estimation with propensity score matching) to correct the potential selection bias. We find that participating in the NCMS significantly decreases the use of traditional Chinese folk doctors and increases the utilization of preventive care, particularly general physical examinations. However, we do not find that the NCMS decreases out-of-pocket expenditure nor do we find that it increases utilization of formal medical service or improves health status, as measured by self-reported health status and by sickness or injury in the past four weeks. Our study indicates that despite the wide expansion of coverage, the impact of the NCMS is still limited. Copyright (C) 2009 John Wiley & Sons, Ltd.