Liu Gordon G, Zhao Zhongyun
Department of Health Economics and Management, Peking University Guanghua School of Management, Room 413, Beijing 100871, China.
Int J Health Plann Manage. 2006 Jul-Sep;21(3):211-28. doi: 10.1002/hpm.846.
Since the middle of the 1990s, China has undertaken a significant reform in urban employee health insurance programs. Using data from the pilot experiment conducted in Zhenjiang, this study examines changes in the pre- and post-reform distributions of out-of-pocket (OOP) expenditures across four representative groups by chronic disease, income, education, and job status. Major findings suggested increased OOP expenditures for all groups after the reform. However, the redistributions in OOP appear to be in favor of the disadvantaged groups, suggesting a more equitable change led by the reform. This study concludes that the post-reform insurance model did not compromise equity in cost-sharing while containing cost inflation and increasing insurance coverage for the urban population.
自20世纪90年代中期以来，中国对城镇职工医疗保险计划进行了重大改革。本研究利用在镇江进行的试点实验数据，考察了按慢性病、收入、教育程度和就业状况划分的四个代表性群体在改革前后自付费用分布的变化。主要研究结果表明，改革后所有群体的自付费用都有所增加。然而，自付费用的重新分配似乎有利于弱势群体，这表明改革带来了更公平的变化。本研究得出结论，改革后的保险模式在控制成本通胀和扩大城镇人口保险覆盖范围的同时，并未损害费用分担的公平性。
