EQUITY OF GOVERNMENT SUBSIDY IN HEALTH CARE- A CASE STUDY IN CHINA
Author(s)
Si L1, Chen M2, Palmer AJ3
1University of Tasmaina, Hobart, Australia, 2Nanjing Medical Univeristy, Nanjing, China, 3Menzies Institute for Medical Research, Hobart, Australia
OBJECTIVES: Monitoring the equity of government healthcare subsidies (GHSs) is critical for evaluating the performance of health policy decisions. The aims of this study were to: 1) Investigate the distribution of GHSs in China; and 2) Compare the equity of GHSs in different healthcare services between urban and rural residents. METHODS: Benefit incidence analysis was applied to GHS data from 2 rounds of China's National Health Services Survey (2003 and 2008, N=27,239). Concentration index (CI), a common standard equity measure, was used to evaluate the equity of GHSs in outpatient and inpatient healthcare services. A negative CI indicates disproportionate concentration of GHSs among the poor, while a positive CI indicates the GHS is pro-rich. In addition, Kakwani index (KI), the difference of the CI and Gini coefficient, was used to evaluate the progressivity of GHSs. A positive KI denotes the GHS is regressive, while a negative value denotes the GHS is progressive. RESULTS: CIs for inpatient care in urban and rural residents were 0.2036 and 0.4497 respectively in 2003, and those in 2008 were 0.4433 and 0.5375. Likewise, CIs for outpatient care are positive in both regions in 2003 and 2008, indicating that both inpatient and outpatient GHSs were pro-rich in both survey periods irrespective of region. In addition, KIs for inpatient services were -0.3769 (urban) and 0.0576 (rural) in 2003 and those in 2008 were 0.0280 and 0.1868. KIs for outpatient service were ‑0.4278 (urban) and ‑0.1257 (rural) in 2003, those in 2008 were -0.2572 and -0.1501, indicating that equity was improved in GHS in outpatient care in both regions but not in inpatient services. CONCLUSIONS: We conclude that high income individuals were the main beneficiaries of GHSs in China, however, the equity in outpatient care improved in both regions.
Conference/Value in Health Info
2016-09, ISPOR Asia Pacific 2016, Singapore
Value in Health, Vol. 19, No. 7 (November 2016)
Code
PHP28
Topic
Health Policy & Regulatory
Topic Subcategory
Health Disparities & Equity
Disease
Multiple Diseases