Urban health insurance reform and coverage in China using data from National Health Services Surveys in 1998 and 2003.
Urban health insurance reform and coverage in China using data from National Health Services Surveys in 1998 and 2003.
复制标题
在1998年和2003年，使用国家卫生服务调查的数据，中国的城市健康保险改革和覆盖范围。
DOI：
10.1186/1472-6963-7-37
复制
发表时间：
2007-03-03
影响因子：
2.8
通讯作者：
Tang, Shenglan
中科院分区：
文献类型：
--
作者：
Xu, Ling;Wang, Yan;Collins, Charles D.;Tang, Shenglan
1997年，中国政府对城镇医疗保险制度进行了重大改革。改革的主要目的是扩大城镇就业人员医疗保险的覆盖范围并控制医疗费用。此次改革后，政府保险计划（GIS）和劳动保险计划（LIS）的双轨制转变为新的城镇职工基本医疗保险计划（BHIS）。本文使用 1998 年和 2003 年国家卫生服务调查的数据来研究改革对人口覆盖率的影响。特别关注性别、年龄、就业状况和收入水平的覆盖范围。在描述这两年的数据之后，本文将讨论保险改革与人口覆盖范围日益不平等之间的关系。对数据的审查揭示了一些关键点： a) 新建立的计划的总体覆盖范围从 1998 年到 2003 年有所下降。 b) 尽管 1997 年改革的目标是提高人口覆盖率，但 1998 年到 2003 年期间，没有任何类型的医疗保险安排的城市人口比例几乎保持不变。 c) 老年群体、男性和高收入群体对主流保险计划（即 GIS-LIS 和 BHIS）的参与程度较高。在某些情况下，系统中的不平等现象正在加剧。 d) 非主流医疗保险计划（包括非商业性和商业性医疗保险）对城镇人口的覆盖范围不断扩大。本文讨论了与城镇保险覆盖相关的三个重要问题：保险形式的制度多样性、劳动力政策以及商业和非商业保险的非主流形式。论文的结论是，巨大的经济发展和扩张并没有导致医疗保险覆盖范围的差距缩小，有限的跨群体补贴和地区不平等是可能的。如果不采取有效措施，妇女、低收入群体、短期合同工、农民工等弱势群体很可能无法分享经济社会发展的成果。
In 1997 there was a major reform of the government run urban health insurance system in China. The principal aims of the reform were to widen coverage of health insurance for the urban employed and contain medical costs. Following this reform there has been a transition from the dual system of the Government Insurance Scheme (GIS) and Labour Insurance Scheme (LIS) to the new Urban Employee Basic Health Insurance Scheme (BHIS). This paper uses data from the National Health Services Surveys of 1998 and 2003 to examine the impact of the reform on population coverage. Particular attention is paid to coverage in terms of gender, age, employment status, and income levels. Following a description of the data between the two years, the paper will discuss the relationship between the insurance reform and the growing inequities in population coverage. An examination of the data reveals a number of key points: a) The overall coverage of the newly established scheme has decreased from 1998 to 2003. b) The proportion of the urban population without any type of health insurance arrangement remained almost the same between 1998 and 2003 in spite of the aim of the 1997 reform to increase the population coverage. c) Higher levels of participation in mainstream insurance schemes (i.e. GIS-LIS and BHIS) were identified among older age groups, males and high income groups. In some cases, the inequities in the system are increasing. d) There has been an increase in coverage of the urban population by non-mainstream health insurance schemes, including non-commercial and commercial ones. The paper discusses three important issues in relation to urban insurance coverage: institutional diversity in the forms of insurance, labour force policy and the non-mainstream forms of commercial and non-commercial forms of insurance. The paper concludes that the huge economic development and expansion has not resulted in a reduced disparity in health insurance coverage, and that limited cross-group subsidy and regional inequality is possible. Unless effective measures are taken, vulnerable groups such as women, low income groups, employees based on short-term contracts and rural-urban migrant workers may well be left out of sharing the social and economic development.
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DOI：
10.1080/09585190110111468
发表时间：
2002-05-01
影响因子：
5.6
作者：
Ding, DZ;Goodall, K;Warner, M
通讯作者：
Warner, M
影响因子：
6.8
作者：
Appleton, S;Knight, J;Xia, QJ
通讯作者：
Xia, QJ
影响因子：
3.2
作者：
Gao, J;Tang, SL;Rao, KQ
通讯作者：
Rao, KQ
影响因子：
5.4
作者：
HENDERSON, G;JIN, SG;GE, KY
通讯作者：
GE, KY
影响因子：
5.4
作者：
LIU, XZ;HSIAO, WCL
通讯作者：
HSIAO, WCL