title: The effects of China's New Cooperative Medical Scheme on accessibility and affordability of healthcare services: an empirical research in Liaoning Province.
abstract: BACKGROUND
  China's New Cooperative Medical Scheme (NCMS), launched in 2003, was intended to prevent the impoverishment due to catastrophic illness costs. Previous studies have been conducted on the "design flows" of the NCMS, for example, the irrational insurance benefit package. But after several years of implementation, very little has been known about the improvements made by the NCMS and rural residents' attitudes toward it. This article specifically focused on the improvements of healthcare services and the enrollees' choices of providers since the implementation of the NCMS in Liaoning province.
  
  
  METHODS
  We conducted a one-on-one interview with healthcare officials in order to get a better understanding of the NCMS policies of the local area. We conducted a door-to-door survey in 3 counties, 21 villages and 602 households to gauge population characteristics, respondents' healthcare preferences, satisfaction levels with providers, and their attitudes towards designated healthcare institutions.
  
  
  RESULTS
  We found that 43.6% of the respondents believed the NCMS brought more convenience to receive healthcare services. 35.2% of the rural residents thought the NCMS work ineffectively, mainly due to the high healthcare costs. 72.3% of the respondents preferred the county hospitals when they got severe diseases, mainly for the reason of better skills and more advanced equipment, while they preferred village clinics (56.5%) and township hospitals (23.2%) when they got minor diseases mainly for the reason of convenience.
  
  
  CONCLUSIONS
  We concluded that the NCMS improved the situation of hard to receive healthcare services but did not reduce the high healthcare fees. Furthermore, participants were unsatisfied with the NCMS designated hospitals. Based on our findings, a number of remedial actions were proposed, including redistributing healthcare resources, developing more domestic medical equipment to lower the treatment costs, and establishing a new talent flow mode.
authors.affiliation: Department of the Health Service Management, China Medical University, No,92 North Second Road, Heping District, Shenyang, Liaoning Province 110001, China (PRC. wxinsmile@qq.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.forename: Xin
authors.initials: X
authors.lastname: He
authors.forename: Ang
authors.initials: A
authors.lastname: Zheng
authors.forename: Xianpu
authors.initials: X
authors.lastname: Ji
mesh_terms: D000328:Adult; D002681:China; D036262:Empirical Research; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007348:Insurance, Health; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration; D017060:Patient Satisfaction; D058996:Quality Improvement; D019035:Rural Health Services / Q000191:economics / Q000592:standards; D012424:Rural Population; D011795:Surveys and Questionnaires