The Effect of New Rural Cooperative Medical Scheme on the Socioeconomic Inequality in Inpatient Service Utilization Among the Elderly in China

Abstract

Background and Aim

Health equity is an important goal of health policy, and the equalization of access to health care plays a vital role in guaranteeing it. The aim of this study was to use the cross-sectional data to explore the effect of New Rural Cooperative Medical Scheme (NRCMS) on the socioeconomic inequality in inpatient service utilization among the elderly in china.

Methods

The data of this study were obtained from the 2018 wave of China Family Panel Studies (CFPS), involving 3645 older adults aged 60 and above. Furthermore, concentration index and concentration curve were employed to measure the socioeconomic inequality in inpatient service utilization. Moreover, this study used multiple linear regression model to explore the effect of NRCMS on inpatient service utilization. In addition, this study adopted the decomposition of concentration index to investigate the effect of NRCMS on the socioeconomic inequality of inpatient service utilization.

Results

The concentration index of inpatient expense for the older people was 0.0538, and its concentration curve lays below the diagonal. The regression result indicates that NRCMS was significantly associated with higher inpatient expense among the elderly (coefficient = 0.8749, p < 0.01). The decomposition result reveals that the contribution rate of NRCMS to concentration index was −2.29%, which indicates that its contribution on reducing pro-rich inequality in inpatient service utilization was limited.

Conclusion

This study demonstrates that there was a pro-rich inequality in inpatient service utilization among the elderly. Furthermore, NRCMS was significantly associated with higher inpatient expense. Moreover, NRCMS only played a limited role in reducing pro-rich inequality in inpatient service utilization.

Keywords:

• socioeconomic inequality
• inpatient service utilization
• elderly
• New Rural Cooperative Medical Scheme
• China

Funding

This study was funded by National Social Science Foundation of China (15BJL003), Shanghai Philosophy and Social Science Planning Project (2014BJL002), National Natural Science Foundation of China (71704108), Research Foundation of Shanghai Municipal Development and Reform Commission of 2018, Scientific Research Foundation of Outstanding Young Teachers of Shanghai Jiao Tong University and SMC of 2016, and Urban Governance Foundation in Humanities and Social Sciences in Shanghai Jiao Tong University (16JCCS16).

Abbreviations

NRCMS, New Rural Cooperative Medical Scheme; CFPS, China Family Panel Studies; VIF, Variance Inflation Factor.

Ethical Statement

This study did not require an ethics committee approval regarding compliance with animal/human ethics guidelines.

Disclosure

The authors report no conflicts on interest in this work.