title: Urban employee health insurance reform and the impact on out-of-pocket payment in China.
abstract: Since the middle of the 1990s, China has undertaken a significant reform in urban employee health insurance programs. Using data from the pilot experiment conducted in Zhenjiang, this study examines changes in the pre- and post-reform distributions of out-of-pocket (OOP) expenditures across four representative groups by chronic disease, income, education, and job status. Major findings suggested increased OOP expenditures for all groups after the reform. However, the redistributions in OOP appear to be in favor of the disadvantaged groups, suggesting a more equitable change led by the reform. This study concludes that the post-reform insurance model did not compromise equity in cost-sharing while containing cost inflation and increasing insurance coverage for the urban population.
authors.affiliation: Department of Health Economics and Management, Peking University Guanghua School of Management, Room 413, Beijing 100871, China. ggliu@unc.edu
authors.forename: Gordon G
authors.initials: GG
authors.lastname: Liu
authors.forename: Zhongyun
authors.initials: Z
authors.lastname: Zhao
mesh_terms: D002681:China; D017047:Cost Sharing / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data* / Q000639:trends; D006264:Health Benefit Plans, Employee / Q000331:legislation & jurisprudence*; D018166:Health Care Reform; D005102:Health Expenditures / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D012935:Social Justice; D011795:Surveys and Questionnaires; D019037:Urban Health Services / Q000191:economics*; D035862:Vulnerable Populations