title: Will China's Cooperative Medical System fail again? Insight from farmer satisfaction survey.
abstract: This paper studied the sustainability of China's New Rural Cooperative Medical System (NCMS) by evaluating the satisfaction rate of its participants-the farmers. The study related the overall satisfaction of the farmers to their satisfaction with the four different aspects of the program. It also identified which personal and program attributes affect the farmers' satisfaction rate. Survey data of 1278 households from 66 counties in Shandong Province of China were collected in 2011 using a multi-stage stratified cluster-sampling method. To overcome the nepotistic barriers in rural China, field surveys in each township were conducted by university students from the same place. Data were analyzed using multiple regressions and structural equation modeling method. The results showed that 86% of the farmers were either satisfied or very satisfied with the NCMS and 82% indicated their intention to continue participating in the program. Aside from its financial benefits, both the publicity and reimbursement procedure of the program were found to be significant factors in influencing the satisfaction of the farmers. Majority of the participants held positive opinions toward the NCMS, contradicting the negative assessments made by many previous studies. Given the high proportion of farmers willing to continue with the program, it is likely to be sustainable in the near future. Greater publicity and education efforts should be made to make the farmers better informed about the program, and measures should be taken to improve its reimbursement procedure and the setting of the premium level.
authors.affiliation: School of Economics, Shandong University, Shandong Province, Jinan, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Chen
authors.affiliation: School of Economics, The University of Queensland, Brisbane, QLD 4072, Australia kk.tang@uq.edu.au.
authors.forename: Kam Ki
authors.initials: KK
authors.lastname: Tang
authors.affiliation: School of Economics, Shandong University, Shandong Province, Jinan, China.
authors.forename: Lifeng
authors.initials: L
authors.lastname: Zhao
authors.affiliation: School of Economics, Shandong University, Shandong Province, Jinan, China.
authors.forename: Yuhong
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003258:Consumer Behavior; D000067565:Farmers / Q000706:statistics & numerical data*; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D008483:Medical Assistance / Q000706:statistics & numerical data*; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D017664:Uncompensated Care / Q000706:statistics & numerical data; D055815:Young Adult
keywords: NCMS; farmer's satisfaction; ordered Logit model; structural equation modeling