title: National Health Insurance Development in China from 2004 to 2011: Coverage versus Benefits.
abstract: BACKGROUND
  The simultaneous improvement of the security capability of China Health Insurance System and its development in the last decade remains uncertain. This study measures the status and trends of reimbursement levels of the China Health Insurance System, as well as to offer policy advice to subsequent insurance reforms.
  
  
  METHODS
  The National Reimbursement Ratio was created to determine the reimbursement level of the national health insurance system based on total health expenditure and the covered population. Chinese total health expenditure data from 2004 to 2011 were extracted from China's Health Statistics according to the standards of the International Classification for Health Accounts by Healthcare Financing.
  
  
  RESULTS
  In 2011, the medical expenditure per capita in China was USD 130.95 and the National Reimbursement Ratio was 26.39%. The National Reimbursement Ratio showed an intense transition from 2004 to 2011, with a sharp decrease from 98.51% in 2004 to 22.44% in 2009, and then a small increase to 26.39% in 2011.
  
  
  CONCLUSIONS
  The National Reimbursement Ratio was effective in revealing the reimbursement level of the national health insurance system and in predicting its trends. The challenge to China's healthcare reform is to switch from increasing insurance coverage to guaranteeing a steady increase in government input and building a powerful supervision mechanism.
authors.affiliation: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China.
authors.forename: Wenxi
authors.initials: W
authors.lastname: Tang
authors.affiliation: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Centre for Health Statistics Information, National Health and Family Planning Commission, People's Republic of China, Beijing, 100044, People's Republic of China.
authors.forename: Yaoguang
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, People's Republic of China.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhang
mesh_terms: D002681:China; D005102:Health Expenditures / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D007342:Insurance Benefits / Q000331:legislation & jurisprudence; D019458:Insurance Coverage / Q000331:legislation & jurisprudence / Q000639:trends*; D009313:National Health Programs / Q000458:organization & administration / Q000706:statistics & numerical data*