We are analyzing https://link.springer.com/article/10.1186/s12913-016-1261-5.

Title:
Outcome-based health equity across different social health insurance schemes for the elderly in China | BMC Health Services Research
Description:
Background Against the achievement of nearly universal coverage for social health insurance for the elderly in China, a problem of inequity among different insurance schemes on health outcomes is still a big challenge for the health care system. Whether various health insurance schemes have divergent effects on health outcome is still a puzzle. Empirical evidence will be investigated in this study. Methods This study employs a nationally representative survey database, the National Survey of the Aged Population in Urban/Rural China, to compare the changes of health outcomes among the elderly before and after the reform. A one-way ANOVA is utilized to detect disparities in health care expenditures and health status among different health insurance schemes. Multiple Linear Regression is applied later to examine the further effects of different insurance plans on health outcomes while controlling for other social determinants. Results The one-way ANOVA result illustrates that although the gaps in insurance reimbursements between the Urban Employee Basic Medical Insurance (UEBMI) and the other schemes, the New Rural Cooperative Medical Scheme (NCMS) and Urban Residents Basic Medical Insurance (URBMI) decreased, out-of-pocket spending accounts for a larger proportion of total health care expenditures, and the disparities among different insurances enlarged. Results of the Multiple Linear Regression suggest that UEBMI participants have better self-reported health status, physical functions and psychological wellbeing than URBMI and NCMS participants, and those uninsured. URBMI participants report better self-reported health than NCMS ones and uninsured people, while having worse psychological wellbeing compared with their NCMS counterparts. Conclusions This research contributes to a transformation in health insurance studies from an emphasis on the opportunity-oriented health equity measured by coverage and healthcare accessibility to concern with outcome-based equity composed of health expenditure and health status. The results indicate that fragmented health insurance schemes generate inequitable health care utilization and health outcomes for the elderly. This study re-emphasizes the importance of reforming health insurance systems based on their health outcome rather than entitlement, which will particularly benefit the most vulnerable older groups.
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28 years and 1 months (reg. 1997-05-29).

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Keywords {🔍}

health, insurance, care, social, status, ncms, outcome, uebmi, article, china, urbmi, elderly, model, table, google, scholar, schemes, participants, psychological, equity, urban, physical, rural, medical, wellbeing, selfreported, groups, coverage, uninsured, support, pubmed, data, expenditures, reform, outofpocket, older, policy, outcomes, regression, functions, increased, means, research, group, study, variables, samples, income, services, people,

Topics {✒️}

cn/syrlzyhshbzb/dongtaixinwen/buneiyaowen/201505/t20150528_162040 cn/guihuaxxs/s10742/201511/191ab1d8c5f240e8b2f5c81524e80f19 article download pdf integrating long-term care outcome-oriented health equity community-based services make outcome-based health equity �outcome-based health equality” complex health-care reforms public health expenditure outcome-based equity composed multiple linear regression outcome-based policy epidemiol public health vulnerable socio-economic status adequate sample size labour market based privacy choices/manage cookies research findings derived conditions privacy policy medical services utilization cooperative medical scheme evidence-based policy creative commons license �outcome-based equity” outcome-based equity health care system policy makers paid urban/rural china collected health care expenditure health care services ensured affordable access outcome-based strategy �opportunity-based equality” distinctive social context health equity issue achieving health equity improving health equity total medical costs policy formulation process government health expenditure state-owned companies social health insurance health insurance schemes long journey ahead soc sci med mental health services health care utilization caregiver providing care health insurance reform

Questions {❓}

Aging and cumulative inequality: how does inequality get under the skin?
Can insurance increase financial risk?
Functional declines, social support, and mental health in the elderly: does living in a state supportive of home and community-based services make a difference?
How could the outcome-based strategy be formalized?
How much might universal health insurance reduce socioeconomic disparities in health?
Non-evidence-based policy: how effective is China’s new cooperative medical scheme in reducing medical impoverishment?

Schema {🗺️}

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         description:Against the achievement of nearly universal coverage for social health insurance for the elderly in China, a problem of inequity among different insurance schemes on health outcomes is still a big challenge for the health care system. Whether various health insurance schemes have divergent effects on health outcome is still a puzzle. Empirical evidence will be investigated in this study. This study employs a nationally representative survey database, the National Survey of the Aged Population in Urban/Rural China, to compare the changes of health outcomes among the elderly before and after the reform. A one-way ANOVA is utilized to detect disparities in health care expenditures and health status among different health insurance schemes. Multiple Linear Regression is applied later to examine the further effects of different insurance plans on health outcomes while controlling for other social determinants. The one-way ANOVA result illustrates that although the gaps in insurance reimbursements between the Urban Employee Basic Medical Insurance (UEBMI) and the other schemes, the New Rural Cooperative Medical Scheme (NCMS) and Urban Residents Basic Medical Insurance (URBMI) decreased, out-of-pocket spending accounts for a larger proportion of total health care expenditures, and the disparities among different insurances enlarged. Results of the Multiple Linear Regression suggest that UEBMI participants have better self-reported health status, physical functions and psychological wellbeing than URBMI and NCMS participants, and those uninsured. URBMI participants report better self-reported health than NCMS ones and uninsured people, while having worse psychological wellbeing compared with their NCMS counterparts. This research contributes to a transformation in health insurance studies from an emphasis on the opportunity-oriented health equity measured by coverage and healthcare accessibility to concern with outcome-based equity composed of health expenditure and health status. The results indicate that fragmented health insurance schemes generate inequitable health care utilization and health outcomes for the elderly. This study re-emphasizes the importance of reforming health insurance systems based on their health outcome rather than entitlement, which will particularly benefit the most vulnerable older groups.
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