Did the distribution of health insurance in China continue to grow less equitable in the nineties? Results from a longitudinal survey
Did the distribution of health insurance in China continue to grow less equitable in the nineties? Results from a longitudinal survey
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DOI：
10.1016/s0277-9536(03)00207-7
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发表时间：
2004-01-01
影响因子：
5.4
通讯作者：
Lance, PM
中科院分区：
文献类型：
--
作者：
Akin, JS;Dow, WH;Lance, PM
本文研究了 1989 年至 1997 年间中国社会经济群体医疗保险分布的变化。该分析基于中国健康与营养调查（CHNS），这是一项针对中国八个省份家庭的独特微观纵向调查。调查结果表明，虽然样本中的总体保险覆盖率在此期间变化不大，但先前指出的某些社会经济群体的覆盖率差异显着缩小。这些发现对以下假设提出了质疑：持续的市场导向改革将导致这些群体的覆盖范围差异扩大。事实上，结果恰恰相反，随着市场导向的变化发生，健康保险覆盖范围的重要差异已经缩小。如果这些减少发生，将对政策产生重要影响。通常出于公平原因而针对的群体似乎随着时间的推移而取得了进展，但这些群体需要不断改进才能达到更幸运的亚群体所享有的覆盖水平。 (C) 2003 Elsevier Ltd. 保留所有权利。
This paper examines changes in the distribution of health insurance across socioeconomic groups in China over the 1989-1997 period. The analysis is based on the China Health and Nutrition Survey (CHNS), a unique micro-level longitudinal survey of households in eight Chinese provinces. Findings indicate that while aggregate insurance coverage rates in the sample changed little over this period, certain previously noted differences in coverage rates across socioeconomic groups narrowed significantly. These findings bring into question the presumption that continued market-oriented reform would lead to increased differences in coverage across those groups. The results, in fact, suggest exactly the opposite, that as the market oriented changes have occurred important disparities in health insurance coverage have been reduced. If these reductions are occurring there are important implications for policy. The groups normally targeted for equity reasons seem to be making progress over time but continued improvements are needed for these groups to reach the levels of coverage enjoyed by more fortunate subgroups. (C) 2003 Elsevier Ltd. All rights reserved.