Health care utilization and affordability among older people following China’s 2009 health reform -- evidence from CHARLS pilot study

• DOI: 10.1186/s12939-019-0969-3
• Publication Date: 2019-05-03T14:02:49Z
• Authors: Jiajia Li; Leiyu Shi; Hailun Liang; Chao Ma; Lingzhong Xu; Wen Qin
• Keywords: Health Services Research; Healthcare Policy; Health Economics; Longitudinal Study; Public health law

In 2009, China unveiled an ambitious national health care reform program, with the goal of providing equitable and affordable basic for everyone. This study was intended to partially fill knowledge gap in understanding demand-side impact on utilization affordability among older people Zhejiang Gansu provinces China. We used two waves data from pilot survey CHARLS implemented 2008 2012. Chi-square tests t were performed examine whether out-of-pocket (OOP) pharmaceutical spending (PS), as a share total expenditures (THEs), have significantly changed following reform. Two-part model employed confirm these changes after controlling confounding variables. All analyses weighted clustered standard errors. After variables, 2012 2.1 6.8% more likely use outpatient inpatient than they did 2008, respectively. Among those who at least one visit, declines OOP-to- THEs PS-to-THEs percentage reduced 0.998 (p < 0.1) 2.324 0.01) 2012, However, conditional having stay, no significant reduction terms OOP-to-THEs even increase observed between Compared elderly Gansu, aged had obviously better utilization, lighter OOP burden lower PS proportion, but higher proportion. Although portion been reform, impacts still limited. Better results can be care, which provide strong foundation next stage