The effect of NCMS on catastrophic health expenditure and impoverishment from tuberculosis care in China.
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BACKGROUND: Health expenditure for tuberculosis (TB) care often pushes households into catastrophe and poverty. New Cooperative Medical Scheme (NCMS) aims to protect households from catastrophic health expenditure (CHE) and impoverishment in rural China. This article assesses the effect of NCMS on relieving CHE and impoverishment from TB care in rural China. METHODS: Three hundred fourty-seven TB cases are included in the analysis. We analyze the incidence and intensity of CHE and poverty, and assess the protective effect of NCMS by comparing the CHE and impoverishment before and after reimbursement. RESULTS: After out-of-pocket (OOP) payment for TB care, 16.1 % of non-poor fall below poverty line. The NCMS reduces the incidence of CHE and impoverishment by 11.5 % and 7.3 %. After reimbursement, 46.7 % of the households still experience CHE and 35.4 % are below the poverty line. The NCMS relieves the mean gap, mean positive gap, poverty gap and normalized positive gap by 44.5 %, 51.0 %, US$115.8 and 31.6 % respectively. CONCLUSIONS: The NCMS has partial effect on protecting households from CHE and impoverishment from TB care. The limited protection could be enhanced by redesigning benefit coverage to improve the "height" of the NCMS and representing fee-for-service with alternative payment mechanisms.
Published Version (Please cite this version)10.1186/s12939-016-0463-0
Publication InfoChen, J; Huan, S; Huang, F; Li, Q; Long, Qian; Lucas, Henry C; ... Zhou, C (2016). The effect of NCMS on catastrophic health expenditure and impoverishment from tuberculosis care in China. Int J Equity Health, 15(1). pp. 172. 10.1186/s12939-016-0463-0. Retrieved from https://hdl.handle.net/10161/15793.
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Assistant Professor of Global Health at Duke Kunshan University
Dr Long had medical and international health training in China and the Netherland. She completed doctoral degree in the University of Helsinki, Finland and had postdoctoral training in Duke Global Health Institute, Duke University and Duke Kunshan University. Her research interest and experience centres on health equity in relation to health systems development with a focus on health financing and health services organization and delivery. She has worked in the area of maternal and child
Mary D.B.T. and James H. Semans International Professor
Areas of Expertise: Health Services Research, Health Policy, Disease Control Strategy, and Implementation Science
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