Urban Health Care Reform Initiative in China: Findings from Its Pilot Experiment in Zhengjiang City (1)

摘要: Abstract This research presents a preliminary assessment of China's urban health care reform experiment. In reforming its existing programs, the Chinese government initiated new community-based insurance plan, which was implemented in pilot experiment 1994. Data for this study derived from first post-experiment survey, conducted Zhengjiang city 1995. The survey contains total 14,745 individuals, 3.2% stratified random sample enrollees city. A two-part econometric model employed as study's analytical framework. Major findings show significant changes cost and utilization patterns response to experimental plan instituted First, incidence using any services increased by 12% among general population. Second, when looking into composition difference services, there shift likelihood inpatient outpatient care. Third, expenditures decreased 8% population 18% users. And fourth, respective service-specific users, rates consistently 14% visits, 11% admissions, 17% length stay (LOS) per admission. Based on these findings, appears be more effective than previous programs. Introduction Over last two decades, system has undergone numerous (Hsiao, 1984; Hu, 1988; Cretin et al., 1990; World Bank, 1993; Henderson 1994; Liu Hsiao, 1995). Like many other countries, runaway costs limited coverage have been serious problems that stimulated publicly financed December 1994, central medical experiments medium-sized cities: Jiujiang (Cai, 1995; Yuen, 1996). intended provide citywide working population, while capping overall spending. hoped eventually following design/testing plan. Given nearly 360 million people live areas, will undoubtedly profound impacts policy transitions markets. To date, only few studies describe Xiang Hillier, 1996; Jiangsu Province Bureau Health, Song, 1997; Yip 1998). major observation most suggested containing (Jiangsu 1997). What remains inconclusive thus far is how savings were particular, some questions raised whether what extent identified attributable reductions various or reduction use expensive diagnostic prescriptions. Moreover, descriptive nature. Because data limitations, none context an explanatory framework controls confounding factors assessing dynamic outcomes resulting Using 1995 Department economic program Zhengjiang. …