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Inequities in the Allocation of Medical Resources in China's Township Health Centers

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Purpose – The purpose of this paper is to produce a high-quality measure of the nature of healthcare resources available in China’s Township Health Centers (THCs), paying particular attention to equity between high- and low-income areas.

Design/methodology/approach – This study makes use of data from a nearly nationally representative survey in rural China conducted by the Center for Chinese Agricultural Policy at the Chinese Academy of Sciences in 2011. The samples of towns were selected randomly from 25 counties located in five provinces from different regions of China. Data were collected through questionnaires and direct observation.

Findings – The THCs located in rich areas have higher levels of human resources than poor areas. THCs in rich areas also have more fixed assets than those in poor areas. In fact, even though the Chinese Ministry of Health mandates that all THCs have certain basic levels of medical equipment and facilities, many THCs in poor areas do not have them. The allocation of mandated equipment is unequal.

Practical implications – These findings suggest that China’s government should pay more attention to THCs located in poor areas, especially in light of new initiatives to improve health care in poor rural areas.

Originality/value – This is the first nationally representative study to employ rigorous empirics to investigate the extent of inequality in allocation of resources within THCs across China.

Keywords China, Health, Inequality, Rural development, Medical resources, Township health centers

Paper type Research paper 

 

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Publication Type
Journal Articles
Publication Date
Journal Publisher
China Agricultural Economic Review
Authors
Yue Ma

A comparison of rural and urban healthcare consumption and health insurance

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Purpose: Since 1999, China has undergone reform of its healthcare system. City‐based social health insurance (SHI) is the primary form of current health insurance, supplemented by various commercial health insurance programs. The rural new cooperative medical system (NCMS) was introduced in 1993 and extended to cover the whole of rural China in 2003.

Design/methodology/approach: The paper developed a theoretical model for consumer demand of medical services and health insurance based on an expected utility framework with a two‐stage decision under uncertainty. The model is then applied to current health insurance systems in China for urban citizens and rural residents separately. Least square and logistic regressions are employed.

Findings: The major results are that although the factors driving the decisions on health insurance participation are basically the same for rural and urban citizens, the participation levels are quite different. The major difference is that urban SHI has higher coverage and urban citizens have higher income, resulting in a much larger urban medical expenditure.

Practical implications: The empirical analysis reveals that health insurance programs have played an important role in the healthcare expenditure for urban residents, while the NCMS has not made a significant impact towards increasing the ability of rural residents to seek more medical services, based on data at 2004.

Originality/value: This is the first paper employing a health production theory on China's new urban and rural healthcare programs.

 

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Publication Type
Journal Articles
Publication Date
Journal Publisher
China Agricultural Economic Review
Authors
Scott Rozelle
Number
2

Good and Bad News From China's New Cooperative Medical Scheme

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Abstract: The overall goal of this article is to understand the progress in implementing the New Cooperative Medical Scheme, while seeking to assess the strengths and weaknesses of the programme and, in particular, to understand its effects on the incidence of catastrophic medical payment. The study is based on two rounds of nationally representative household survey data collected in 2005 and 2008. The study found that the programme has a very high level of participation, and has increased farmers’ use of medical services. However, despite efforts by both central and local governments and high household participation, the programme is only partially achieving its policy objectives. In particular, it has been able to extend to almost all of the rural population, but has failed to cover expenses for catastrophic illness, due to insufficient funds.

 

Abstract The overall goal of this article is to understand the progress in implementing the New Cooperative

 

Medical Scheme, while seeking to assess the strengths and weaknesses of the programme and, in particular,

to understand its effects on the incidence of catastrophic medical payment. The study is based on two

rounds of nationally representative household survey data collected in 2005 and 2008. The study found that

the programme has a very high level of participation, and has increased farmers’ use of medical services.

However, despite efforts by both central and local governments and high household participation, the

programme is only partially achieving its policy objectives. In particular, it has been able to extend to almost

all of the rural population, but has failed to cover expenses for catastrophic illness, due to insufficient funds.

All Publications button
1
Publication Type
Journal Articles
Publication Date
Journal Publisher
IDS Bulletin
Authors
Scott Rozelle
Number
4
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