Department of Health Economics, Fudan University, Shanghai, China.
Trop Med Int Health. 2010 Apr;15(4):468-75. doi: 10.1111/j.1365-3156.2010.02469.x. Epub 2010 Feb 17.
China has implemented the New Cooperative Medical Scheme (NCMS) in rural areas since 2003 to provide financial protection to its rural population. This article explores the effect of NCMS on relieving catastrophic health expenditure (CHE) among the poor and non-poor groups.
A questionnaire survey was conducted in three counties, with a random sample of 358 poor and 523 non-poor NCMS enrollees who used inpatient services and obtained NCMS reimbursement in 2005.
Majority of NCMS enrollees suffered CHE because of using inpatient services; the occurrence and intensity of CHE was greater among poor inpatients. NCMS reimbursement helped relieve CHE to a certain degree. Poor inpatients benefited more from NCMS than non-poor, but the effects varied among counties. Cost control measures and other medical financial assistance (MFA) helped reduce inpatients' economic burden.
The objective of NCMS is only partly achieved. However, NCMS has promoted equity in health financing as poor inpatients can acquire more protection than the non-poor. Our analysis suggests that efforts should be made to improve NCMS design, strengthen cost containment and extend other MFA to further relieve economic burden of disease.
中国自 2003 年以来在农村地区实施了新型农村合作医疗制度（NCMS），为农村人口提供经济保障。本文旨在探讨 NCMS 对减轻贫困和非贫困人群灾难性卫生支出（CHE）的影响。
在三个县进行了问卷调查，随机抽取了 2005 年使用住院服务并获得 NCMS 报销的 358 名贫困和 523 名非贫困 NCMS 参保人作为样本。
大多数 NCMS 参保人因住院而遭受 CHE；贫困住院患者发生和承受 CHE 的程度更大。NCMS 报销在一定程度上有助于减轻 CHE。贫困住院患者比非贫困患者从 NCMS 中受益更多，但各县的效果不同。费用控制措施和其他医疗财政援助（MFA）有助于减轻住院患者的经济负担。
NCMS 的目标仅部分实现。然而，NCMS 促进了卫生筹资公平，因为贫困住院患者比非贫困患者获得更多的保护。我们的分析表明，应努力改进 NCMS 设计，加强费用控制，并扩大其他 MFA，以进一步减轻疾病的经济负担。
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