title: Effects of China's New Rural Cooperative Medical Scheme on reducing medical impoverishment in rural Yanbian: An alternative approach.
abstract: This study aimed to measure the poverty head count ratio and poverty gap of rural Yanbian in order to examine whether China's New Rural Cooperative Medical Scheme has alleviated its medical impoverishment and to compare the results of this alternative approach with those of a World Bank approach.
  
  
  
  This cross-sectional study was based on a stratified random sample survey of 1,987 households and 6,135 individuals conducted in 2008 across eight counties in Yanbian Korean Autonomous Prefecture, Jilin province, China. A new approach was developed to define and identify medical impoverishment. The poverty head count ratio, relative poverty gap, and average poverty gap were used to measure medical impoverishment. Changes in medical impoverishment after the reimbursement under the New Rural Cooperative Medical Scheme were also examined.
  
  
  
  The government-run New Rural Cooperative Medical Scheme reduced the number of medically impoverished households by 24.6 %, as well as the relative and average gaps by 37.3 % and 38.9 %, respectively.
  
  
  
  China's New Rural Cooperative Medical Scheme has certain positive but limited effects on alleviating medical impoverishment in rural Yanbian regardless of how medical impoverishment is defined and measured. More governmental and private-sector efforts should therefore be encouraged to further improve the system in terms of financing, operation, and reimbursement policy.
authors.affiliation: Research Institute of Health Development Strategies, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, 130 Dong An Road, Shanghai, 200032, China.
authors.forename: Mei
authors.initials: M
authors.lastname: Sun
authors.affiliation: Department of Health Care Administration and Policy, School of Community Health Sciences, University of Nevada, Las Vegas, 4505 S. Maryland Parkway, Box 453023, Las Vegas, NV, 89154-3023, USA.
authors.forename: Jay J
authors.initials: JJ
authors.lastname: Shen
authors.affiliation: Research Institute of Health Development Strategies, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, 130 Dong An Road, Shanghai, 200032, China.
authors.forename: Chengyue
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Health Care Administration and Policy, School of Community Health Sciences, University of Nevada, Las Vegas, 4505 S. Maryland Parkway, Box 453023, Las Vegas, NV, 89154-3023, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Cochran
authors.affiliation: Research Institute of Health Development Strategies, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, 130 Dong An Road, Shanghai, 200032, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Research Institute of Health Development Strategies, Fudan University, 130 Dong An Road, Shanghai, 200032, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Chen
authors.affiliation: Research Institute of Health Development Strategies, Fudan University, 130 Dong An Road, Shanghai, 200032, China.
authors.forename: Pingping
authors.initials: P
authors.lastname: Li
authors.affiliation: Research Institute of Health Development Strategies, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, 130 Dong An Road, Shanghai, 200032, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Lu
authors.affiliation: Research Institute of Health Development Strategies, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, 130 Dong An Road, Shanghai, 200032, China.
authors.forename: Fengshui
authors.initials: F
authors.lastname: Chang
authors.affiliation: Research Institute of Health Development Strategies, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, 130 Dong An Road, Shanghai, 200032, China.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Li
authors.affiliation: Research Institute of Health Development Strategies, Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, 130 Dong An Road, Shanghai, 200032, China. haomo03@fudan.edu.cn.
authors.forename: Mo
authors.initials: M
authors.lastname: Hao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D005378:Financial Support; D019538:Health Care Surveys; D006291:Health Policy / Q000191:economics*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011203:Poverty; D019035:Rural Health Services / Q000191:economics* / Q000458:organization & administration / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Evaluation approach; Medical impoverishment; New rural cooperative medical scheme; Policy effects; Poverty; Rural