2023-09-28 14:46:10 +00:00
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abstract: 'Background: In 1997 there was a major reform of the government run urban
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health insurance system in China. The principal aims of the reform were
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to widen coverage of health insurance for the urban employed and contain
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medical costs. Following this reform there has been a transition from
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the dual system of the Government Insurance Scheme ( GIS) and Labour
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Insurance Scheme ( LIS) to the new Urban Employee Basic Health Insurance
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Scheme ( BHIS).
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Methods: This paper uses data from the National Health Services Surveys
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of 1998 and 2003 to examine the impact of the reform on population
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coverage. Particular attention is paid to coverage in terms of gender,
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age, employment status, and income levels. Following a description of
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the data between the two years, the paper will discuss the relationship
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between the insurance reform and the growing inequities in population
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coverage.
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Results: An examination of the data reveals a number of key points:
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a) The overall coverage of the newly established scheme has decreased
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from 1998 to 2003.
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b) The proportion of the urban population without any type of health
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insurance arrangement remained almost the same between 1998 and 2003 in
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spite of the aim of the 1997 reform to increase the population coverage.
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c) Higher levels of participation in mainstream insurance schemes ( i.
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e. GIS-LIS and BHIS) were identified among older age groups, males and
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high income groups. In some cases, the inequities in the system are
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increasing.
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d) There has been an increase in coverage of the urban population by
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non-mainstream health insurance schemes, including non-commercial and
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commercial ones.
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The paper discusses three important issues in relation to urban
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insurance coverage: institutional diversity in the forms of insurance,
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labour force policy and the non-mainstream forms of commercial and
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non-commercial forms of insurance.
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Conclusion: The paper concludes that the huge economic development and
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expansion has not resulted in a reduced disparity in health insurance
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coverage, and that limited cross-group subsidy and regional inequality
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is possible. Unless effective measures are taken, vulnerable groups such
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as women, low income groups, employees based on short-term contracts and
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rural-urban migrant workers may well be left out of sharing the social
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and economic development.'
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affiliation: 'Wang, Y (Corresponding Author), Univ Liverpool, Liverpool Sch Trop Med,
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Pembroke Pl, Liverpool L3 5QA, Merseyside, England.
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Univ Liverpool, Liverpool Sch Trop Med, Liverpool L3 5QA, Merseyside, England.
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Minist Hlth, Ctr Hlth Stat \& Informat, Beijing, Peoples R China.'
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article-number: '37'
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author: Xu, Ling and Wang, Yan and Collins, Charles D. and Tang, Shenglan
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author-email: 'xuling@moh.gov.cn
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yan.wang@liverpool.ac.uk
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chascollins@tiscali.co.uk
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s.tang@liverpool.ac.uk'
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author_list:
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- family: Xu
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given: Ling
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- family: Wang
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given: Yan
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- family: Collins
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given: Charles D.
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- family: Tang
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given: Shenglan
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da: '2023-09-28'
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doi: 10.1186/1472-6963-7-37
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files: []
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issn: 1472-6963
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journal: BMC HEALTH SERVICES RESEARCH
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keywords-plus: ECONOMIC-REFORM; ACCESS
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language: English
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month: MAR 3
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number-of-cited-references: '30'
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papis_id: 866ff0cef3327655b6da96957dac47bd
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ref: Xu2007urbanhealth
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researcherid-numbers: Tang, Shenglan/AAO-7403-2020
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times-cited: '78'
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title: Urban health insurance reform and coverage in China using data from National
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Health Services Surveys in 1998 and 2003
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000245025300001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '47'
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volume: '7'
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web-of-science-categories: Health Care Sciences \& Services
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year: '2007'
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