期刊
INTERNATIONAL JOURNAL OF PUBLIC HEALTH
卷 57, 期 1, 页码 193-198出版社
SPRINGER BASEL AG
DOI: 10.1007/s00038-011-0251-y
关键词
Influenza; Out-of-pocket expenditure; Trends; China; Policy implication
资金
- National Institute of Nutrition and Food Safety
- China Center for Disease Control and Prevention
- Carolina Population Center
- University of North Carolina at Chapel Hill
- NIH [R01-HD30880, DK056350, R01-HD38700]
- Fogarty International Center, NIH
- China-Japan Friendship Hospital, Ministry of Health
To examine the trends of out-of-pocket expenditure for influenza during 1989-2006 in China. Data were extracted from the China Health and Nutrition Survey (CHNS) during 1989-2006 (in seven waves). A fixed effect model with robust standard errors was employed to examine trends of out-of-pocket expenditure (adjusted to 2006 Chinese RMB). The out-of-pocket expenditure increased from 11.92 RMB in 1989 to 50.75 RMB in 2006. The final sample for fixed effect model was 23,050 households. Income elasticity of out-of-pocket expenditure was 1.6%. Using 1989 as reference, the predicted increase was 242.23% [95% confidence interval (CI): 225.79-259.50%] in 2006; it was 143.54% in city hospitals [95% CI: 130.43-157.40%] compared to village clinics. Adjusted for inflation and income elasticity, Chinese households experienced an increase of more than double the out-of-pocket expenditure during 1989-2006. The expenditure was higher in higher-level facilities. Policy implications include the government fixed-budget financing to health providers could contribute to the rapidly increased financial burden; a referral system should be rebuilt; private health providers may play an important role in containing healthcare price in China.
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