Study on hospitalization benefit equity of the basic medical insurance programs in China / 中国卫生政策研究

Objective: To analyze the equity of benefit for inpatient services under the three basic medical insurance programs in China.Methods: Using the baseline survey data collected by China Family Panel Studies (CFPS) in 2010, and the two-part model was applied to explore whether the insured groups with different income levels had different aspects on inpatient rate and the compensation of hospitalization expenses in health insurance coverage.Results: There was no significant difference in the inpatient service utilization rate for different income groups, but the highest and second highest income groups reimburse more expenses than the lowest income group, that is 36.5% and 26.3%, respectively.Specifically, the income level and the compensation amount are not significantly correlated in the Urban Employer Medical Insurance (UEMI) program;the compensation amounts to be paid by urban residents are basically increasing with the increase of the income level;and there is a moderate discrepancy between the highest and the lowest income groups in the New Rural Cooperative Medical System (NCMS).Conclusion: The benefit equity is obviously fair in terms of inpatient service utilization rate, but the benefit degree increases for higher income groups, which shows that there are unfair inequalities related to the income at the level of reimbursement.In terms of program comparison, the benefit degree equity is higher for the UEMI program, followed by the URMI program and the NCMS program is the worst.Besides, the impatient rate and reimbursement amounts are significantly lower for NCMS program participants.The government should merge URMI and NCMS programs, actively promote the integration of basic medical insurance system by strengthening the construction of the medical assistance system and improving the system of catastrophic disease medical expenditure insurance in order to achieve better benefit equity.

Analyzing the Benefit Equity in China’s Basic Health Insurance System / 中国卫生经济

Objective: To analyze the equity of benefit which residents with different income get from Urban Employee Medical Insurance ( UEMI) and New Rural Cooperative Medical System (NCMS). Methods: Data used in this study is based on the forth household health service survey in Shanxi province. The indirectly standardization method and concentration index were employed to analyze the horizontal inequity index of benefit rate and benefit degree. Results:The horizontal inequity index of benefit rate and benefit degree in UEMI are 0.0524 and 0.0025, and the horizontal inequity index of benefit rate and benefit degree in NCMS are 0.2312 and 0.3228. Conclusion: The urban residents get the equal benefit from UEM, and there were pro-rich horizontal inequities of benefit rate and benefit degree in NCMS.