Health payment-induced poverty under China's New Cooperative Medical Scheme in rural Shandong

Abstract

Objective To measure the incidence and severity of health payment-induced poverty of rural households under the New Cooperative Medical Scheme (NCMS) in rural Shandong, China.Method We collected primary data from a household survey to identify catastrophic health payments and measure associated health payment-induced poverty in a county of Shandong province. From a stratified random cluster sample of 3101 households, 375 households that might be at risk of catastrophic payments were identified and interviewed. A validity test of the screening method was conducted, from which we obtained the adjusted total number of households with catastrophic payments in the sample of 3101. The health payment-induced poverty incidence and severity were compared without and with NCMS reimbursements.Results Before the NCMS intervention, 5.06 of the sample households fell below the national poverty line due to health payments in 2004, compared with 4.03 after reimbursements. With NCMS reimbursements, the health payment-induced poverty gap of those households still remaining below the Chinese national poverty line dropped by 19.2 to an average of 977.2 Yuan.Conclusion Out-of-pocket health payments remain a severe burden for rural households. Financial protection from the NCMS was limited. Show more