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An evaluation of China’s new rural cooperative medical system: achievements and inadequacies from policy goals

Overview of attention for article published in BMC Public Health, October 2015
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Title
An evaluation of China’s new rural cooperative medical system: achievements and inadequacies from policy goals
Published in
BMC Public Health, October 2015
DOI 10.1186/s12889-015-2410-1
Pubmed ID
Authors

Chengyue Li, Yilin Hou, Mei Sun, Jun Lu, Ying Wang, Xiaohong Li, Fengshui Chang, Mo Hao

Abstract

Although much public scrutiny and academic attention has focused on the evaluations of system implementation since the beginning of New Rural Cooperative Medical System (NRCMS) in China, few studies have systematically evaluated the achievements of the stated policy goals. The purpose of this study is to examine to what extent the policy goals of NRCMS have been achieved. Using multistage sampling processes, two rounds of cross-sectional household surveys including 9787 and 7921 rural households were conducted in Eastern China in year 2000 and year 2008, respectively. A pre- and post-implementation comparison was used to evaluate the achievement of policy goals in three measures: impoverishment from major health hazards, household financial risk from medical expenses, and rural income inequity. Intention surveys were also applied to find out potential obstacles in the implementation of NRCMS. The rate of re-impoverishment from health hazard was reduced from 2.69 % ex ante to 2.12 % ex post, a decrease of 21.13 %. The severity of impoverishment fell from a previous 4.66 % to 3.02 %, a decline of 35.18 %. Economic risk of medical treatment population relative to the whole population fell from 2.62 ex ante to 2.03 ex post, a 22.52 % reduction. As indication of effect on improving income equity, the Gini coefficient fell from 0.4629 to 0.4541. The effects of NRCMS were significantly better than those of RCMS. Despite the preliminary achievements, our intention survey of key respondents identified that technical difficulties in actuarial funding and more sustainable reimbursement schedules has become the most challenging barriers in achieving the goals of NRCMS, while raising the insurance premium on NRCMS was no longer as big a barrier. With NRCMS, China has established a medical security system to reduce the financial burden of healthcare on rural residents. NRCMS has achieved some positive though limited effects; but technical difficulties in the implementation of NRCMS have become barriers to achieve the pre-set policy goals. Efforts should be made to improve the capacity building in the design of the reimbursement schemes for the implementers of NRCMS, such as identifying medical impoverishment, calculating actuarial funding levels for the risk pooling.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 47 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 2%
Unknown 46 98%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 15 32%
Student > Master 6 13%
Student > Doctoral Student 5 11%
Student > Bachelor 3 6%
Student > Postgraduate 2 4%
Other 7 15%
Unknown 9 19%
Readers by discipline Count As %
Nursing and Health Professions 8 17%
Social Sciences 7 15%
Economics, Econometrics and Finance 5 11%
Medicine and Dentistry 5 11%
Psychology 3 6%
Other 8 17%
Unknown 11 23%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 October 2015.
All research outputs
#4,766,755
of 6,447,265 outputs
Outputs from BMC Public Health
#5,228
of 6,134 outputs
Outputs of similar age
#140,700
of 206,954 outputs
Outputs of similar age from BMC Public Health
#226
of 278 outputs
Altmetric has tracked 6,447,265 research outputs across all sources so far. This one is in the 14th percentile – i.e., 14% of other outputs scored the same or lower than it.
So far Altmetric has tracked 6,134 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.9. This one is in the 6th percentile – i.e., 6% of its peers scored the same or lower than it.
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We're also able to compare this research output to 278 others from the same source and published within six weeks on either side of this one. This one is in the 9th percentile – i.e., 9% of its contemporaries scored the same or lower than it.