title: Whether New Cooperative Mmedical Schemes reduce the economic burden of chronic disease in rural China.
abstract: BACKGROUND
  The New Cooperative Medical Scheme (NCMS) provides health insurance coverage for rural populations in China. This study aimed to evaluate changes in household catastrophic health expenditure (CHE) due to chronic disease before and after the reimbursement policies for services of chronic disease were implemented to provide additional financial support.
  
  
  METHODS
  The study used data from the household surveys conducted in Shandong Province and Ningxia Hui Autonomous Region in 2006 and 2008. The study sample in village-level units was divided into two groups: 36 villages which implemented the NCMS reimbursement policies for chronic diseases as the intervention group, and 72 villages which did not as the control group. Health care expenditure of more than 40% of household's non-food expenditure was defined as a household with CHE (i.e., impoverishment). The conceptual framework was established based on the Andersen socio-behavioral model of health care utilization to explore how the NCMS reimbursement policies impacted health expenditures. A difference-in-difference model was employed to compare the change in the proportion of households incurring CHE due to chronic disease between the two groups over time.
  
  
  RESULTS
  The households that participated in the NCMS were less likely to become impoverished (P<0.05). In addition, the households with both male household head and higher income level were protective factors to prevent CHE (P<0.05). Young households with preschool children suffered less from CHE (P<0.05). The effect of the NCMS reimbursement policies for chronic disease on the CHE was negative, yet not statistically significant (p = 0.814).
  
  
  CONCLUSIONS
  The NCMS coverage showed financial protection for households with chronic disease. However, the NCMS reimbursement policies should be strengthened in the future.
authors: Center for Health Management and Policy, Shandong University, Ji'nan, Shandong Province, China.
authors: Shanshan
authors: S
authors: Jing
authors: Aitian
authors: A
authors: Yin
authors: Lizheng
authors: L
authors: Shi
authors: Jinan
authors: J
authors: Liu
mesh_terms: D000465:Algorithms; D002681:China; D002908:Chronic Disease / Q000191:economics*; D003153:Community Health Services / Q000191:economics* / Q000706:statistics & numerical data; D017281:Cost of Illness; D005191:Family Characteristics; D005260:Female; D005380:Financing, Government / Q000191:economics*; D006801:Humans; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D018803:Models, Economic; D012423:Rural Health / Q000191:economics / Q000706:statistics & numerical data; D019035:Rural Health Services / Q000191:economics* / Q000706:statistics & numerical data