Skip to main content
Journal cover image

Balancing the funds in the New Cooperative Medical Scheme in rural China: determinants and influencing factors in two provinces.

Publication ,  Journal Article
Zhang, L; Cheng, X; Liu, X; Zhu, K; Tang, S; Bogg, L; Dobberschuetz, K; Tolhurst, R
Published in: Int J Health Plann Manage
2010

In recent years, the central government in China has been leading the re-establishment of its rural health insurance system, but local government institutions have considerable flexibility in the specific design and management of schemes. Maintaining a reasonable balance of funds is critical to ensure that the schemes are sustainable and effective in offering financial protection to members. This paper explores the financial management of the NCMS in China through a case study of the balance of funds and the factors influencing this, in six counties in two Chinese provinces. The main data source is NCMS management data from each county from 2003 to 2005, supplemented by: a household questionnaire survey, qualitative interviews and focus group discussions with all local stakeholders and policy document analysis. The study found that five out of six counties held a large fund surplus, whilst enrolees obtained only partial financial protection. However, in one county greater risk pooling for enrolees was accompanied by relatively high utilisation levels, resulting in a fund deficit. The opportunities to sustainably increase the financial protection offered to NCMS enrolees are limited by the financial pressures on local government, specific political incentives and low technical capacities at the county level and below. Our analysis suggests that in the short term, efforts should be made to improve the management of the current NCMS design, which should be supported through capacity building for NCMS offices. However, further medium-term initiatives may be required including changes to the design of the schemes.

Duke Scholars

Published In

Int J Health Plann Manage

DOI

EISSN

1099-1751

Publication Date

2010

Volume

25

Issue

2

Start / End Page

96 / 118

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • State Medicine
  • Rural Population
  • Interviews as Topic
  • Health Policy & Services
  • Financial Management
  • China
  • 4407 Policy and administration
  • 4206 Public health
  • 4203 Health services and systems
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Zhang, L., Cheng, X., Liu, X., Zhu, K., Tang, S., Bogg, L., … Tolhurst, R. (2010). Balancing the funds in the New Cooperative Medical Scheme in rural China: determinants and influencing factors in two provinces. Int J Health Plann Manage, 25(2), 96–118. https://doi.org/10.1002/hpm.988
Zhang, Luying, Xiaoming Cheng, Xiaoyun Liu, Kun Zhu, Shenglan Tang, Lennart Bogg, Karin Dobberschuetz, and Rachel Tolhurst. “Balancing the funds in the New Cooperative Medical Scheme in rural China: determinants and influencing factors in two provinces.Int J Health Plann Manage 25, no. 2 (2010): 96–118. https://doi.org/10.1002/hpm.988.
Zhang L, Cheng X, Liu X, Zhu K, Tang S, Bogg L, et al. Balancing the funds in the New Cooperative Medical Scheme in rural China: determinants and influencing factors in two provinces. Int J Health Plann Manage. 2010;25(2):96–118.
Zhang, Luying, et al. “Balancing the funds in the New Cooperative Medical Scheme in rural China: determinants and influencing factors in two provinces.Int J Health Plann Manage, vol. 25, no. 2, 2010, pp. 96–118. Pubmed, doi:10.1002/hpm.988.
Zhang L, Cheng X, Liu X, Zhu K, Tang S, Bogg L, Dobberschuetz K, Tolhurst R. Balancing the funds in the New Cooperative Medical Scheme in rural China: determinants and influencing factors in two provinces. Int J Health Plann Manage. 2010;25(2):96–118.
Journal cover image

Published In

Int J Health Plann Manage

DOI

EISSN

1099-1751

Publication Date

2010

Volume

25

Issue

2

Start / End Page

96 / 118

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • State Medicine
  • Rural Population
  • Interviews as Topic
  • Health Policy & Services
  • Financial Management
  • China
  • 4407 Policy and administration
  • 4206 Public health
  • 4203 Health services and systems