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Trends and socio-economic disparities in catastrophic health expenditure and health impoverishment in China: 2010 to 2016.

Publication ,  Journal Article
Zhao, Y; Oldenburg, B; Mahal, A; Lin, Y; Tang, S; Liu, X
Published in: Trop Med Int Health
February 2020

OBJECTIVES: To investigate trends and socio-economic disparities in the catastrophic health expenditure (CHE) and health impoverishment in China after major reform of the health system and to examine the impacts of the chronic disease on CHE and impoverishment. METHODS: We obtained data from four rounds of the China Family Panel Studies 2010-2016, with a sample size of 14 960 households. We defined CHE as the point at which annual household health payments exceeded 40% of annual capacity to pay. Impoverishment is measured by the $1.90 per day poverty line. Multivariate logistic regression models were performed to identify impacts of the family member with chronic disease on CHE and impoverishment. RESULTS: Between 2010 and 2016, the incidence of CHE in China decreased from 19.37% to 15.11% and from 7.39% to 5.14% for health impoverishment; however, the decrease in level of impoverishment was less in rural areas (from 6.16% down to 3.03%) than in urban areas (from 8.46% down to 7.81%). The gap between impoverishment rates across the income quartiles is growing. Multivariable analysis showed that households with two or more members suffering chronic diseases were significantly more likely to incur CHE (aOR: 2.46, 95% CI: 1.93-3.13) and impoverishment (aOR: 2.66, 95% CI: 1.87-3.78) than households with no members suffering chronic diseases, after adjusting for sociodemographic covariates. CONCLUSIONS: Important advances have been made in achieving greater financial protection for Chinese citizens. Nevertheless, greater attention to the poor households with chronic disease members is needed. Policymakers in China should focus on optimising integrated rural-urban health insurance by expanding the current benefit packages and strengthening poverty alleviation efforts.

Duke Scholars

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Published In

Trop Med Int Health

DOI

EISSN

1365-3156

Publication Date

February 2020

Volume

25

Issue

2

Start / End Page

236 / 247

Location

England

Related Subject Headings

  • Tropical Medicine
  • Poverty
  • Male
  • Insurance Coverage
  • Humans
  • Health Policy
  • Health Expenditures
  • Female
  • China
  • Catastrophic Illness
 

Citation

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Zhao, Y., Oldenburg, B., Mahal, A., Lin, Y., Tang, S., & Liu, X. (2020). Trends and socio-economic disparities in catastrophic health expenditure and health impoverishment in China: 2010 to 2016. Trop Med Int Health, 25(2), 236–247. https://doi.org/10.1111/tmi.13344
Zhao, Yang, Brian Oldenburg, Ajay Mahal, Yaqi Lin, Shenglan Tang, and Xiaoyun Liu. “Trends and socio-economic disparities in catastrophic health expenditure and health impoverishment in China: 2010 to 2016.Trop Med Int Health 25, no. 2 (February 2020): 236–47. https://doi.org/10.1111/tmi.13344.
Zhao Y, Oldenburg B, Mahal A, Lin Y, Tang S, Liu X. Trends and socio-economic disparities in catastrophic health expenditure and health impoverishment in China: 2010 to 2016. Trop Med Int Health. 2020 Feb;25(2):236–47.
Zhao, Yang, et al. “Trends and socio-economic disparities in catastrophic health expenditure and health impoverishment in China: 2010 to 2016.Trop Med Int Health, vol. 25, no. 2, Feb. 2020, pp. 236–47. Pubmed, doi:10.1111/tmi.13344.
Zhao Y, Oldenburg B, Mahal A, Lin Y, Tang S, Liu X. Trends and socio-economic disparities in catastrophic health expenditure and health impoverishment in China: 2010 to 2016. Trop Med Int Health. 2020 Feb;25(2):236–247.
Journal cover image

Published In

Trop Med Int Health

DOI

EISSN

1365-3156

Publication Date

February 2020

Volume

25

Issue

2

Start / End Page

236 / 247

Location

England

Related Subject Headings

  • Tropical Medicine
  • Poverty
  • Male
  • Insurance Coverage
  • Humans
  • Health Policy
  • Health Expenditures
  • Female
  • China
  • Catastrophic Illness