Measuring financial protection for health in families with chronic conditions in Rural China.
Measuring financial protection for health in families with chronic conditions in Rural China.
复制标题
DOI：
10.1186/1471-2458-12-988
复制
发表时间：
2012-11-16
影响因子：
4.5
通讯作者：
Luo W
中科院分区：
文献类型：
--
作者：
Jiang C;Ma J;Zhang X;Luo W
作为世界上最大的发展中国家，中国已进入高预期寿命、高慢性病发病率和死亡率的流行病学阶段。自1990年代以来，心血管疾病、慢性阻塞性肺疾病和恶性肿瘤已成为死亡的主要原因。为维持患有慢性病的家庭成员的健康状况而不断支付费用可能耗尽家庭资源，削弱对其他必需品的财政支持，最终导致贫困。本研究的目的是探讨慢性病医疗费用对农村家庭的损害程度，以及新型农村合作医疗制度能否有效地保护慢性病患者家庭免受灾难性医疗费用的影响。我们使用的数据来自2008年7月在中国进行的第四次全国卫生服务调查。我们分析的农村样本包括39，054户家庭。我们使用了两个家庭遭受的医疗费用和家庭的灾难性的健康支出，比较的财务保护有一个慢性病人的家庭与不同的保险覆盖状况。我们使用逻辑回归模型来估计不同的福利方案对慢性病患者家庭的健康财务保护的影响。另有10.53%的慢性病患者家庭因医疗支出而陷入贫困，这一比例是没有慢性病患者的家庭的两倍多。有慢性病患者的家庭灾难性卫生支出发生率较高。Logistic回归分析结果表明，单纯增加额外收益并不能降低财务风险。尽管新型农村合作医疗的覆盖率很高，但中国农村慢性病患者家庭的医疗支出缺乏有效的经济保障。鉴于新型农村合作医疗即将实现全民覆盖，中央政府在风险池中的资金不断增加，通过对筹资机制和支付方式进行系统的改革，应该有可能为家庭提供有效的财务保护。
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. We used data from the 4th 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. 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. 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.
登录
查看更多内容
影响因子：
2.1
作者：
Lei, Xiaoyan;Lin, Wanchuan
通讯作者：
Lin, Wanchuan
影响因子：
9.7
作者：
Druss, BG;Marcus, SC;Pincus, HA
通讯作者：
Pincus, HA
影响因子：
5.4
作者：
Abegunde, Dele Oawale;Stanciole, Anderson E.
通讯作者：
Stanciole, Anderson E.
DOI：
10.2471/blt.06.033720
发表时间：
2007-08-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Limwattananon, Supon;Tangcharoensathien, Viroj;Prakongsai, Phusit
通讯作者：
Prakongsai, Phusit
影响因子：
6.9
作者：
Carter, MR;Maluccio, JA
通讯作者：
Maluccio, JA