Perceived effect of financial risk protection by the Urban-Rural Resident Basic Medical Insurance Scheme: a mixed-methods study of rural residents in China.

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Tytuł:: Perceived effect of financial risk protection by the Urban-Rural Resident Basic Medical Insurance Scheme: a mixed-methods study of rural residents in China.
Autorzy:: Jiang H; Humanities and Social Sciences College, Harbin Medical University, Harbin, China.
Zhao M; Department of health management, Shcool of public health, Nantong university, Nantong, Jiangsu,China.
Tian G; Fourth affiliate hospital of Harbin Medical University, Harbin, Heilongjiang,China.
Zhao Z; Scientific Research Department, Harbin Medical University, Harbin, Heilongjiang, China.
Ding D; Department of Social Medicine, Dalian Medical University, Dalian, China.
Yin M; Humanities and Social Sciences College, Harbin Medical University, Harbin, China .
Źródło:: BMJ open [BMJ Open] 2021 Oct 19; Vol. 11 (10), pp. e047699. Date of Electronic Publication: 2021 Oct 19.
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
MeSH Terms:: Insurance*
Rural Population*
Ambulatory Care ; China ; Cross-Sectional Studies ; Humans ; Insurance, Health
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Contributed Indexing:: Keywords: health policy; qualitative research; quality in health care
Entry Date(s):: Date Created: 20211020 Date Completed: 20211102 Latest Revision: 20211105
Update Code:: 20240105
PubMed Central ID:: PMC8527163
DOI:: 10.1136/bmjopen-2020-047699
PMID:: 34667000
: Czasopismo naukowe

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Objectives: It is to explore the perceived financial risk protection effect of the Urban-Rural Resident Basic Medical Insurance Scheme (URRBMI) and its influencing factors to provide evidence to further improve the URRBMI.
Design: It is a cross-sectional survey.
Participants: This mixed-methods study is conducted in five provinces in rural China. Through stratified cluster random sampling, 1681 rural residents participate in a cross-sectional questionnaire survey (1657 valid questionnaires are retrieved). Thirty rural residents participate in in-depth interviews.
Primary and Secondary Outcome Measures: A multivariate logistic regression analysis is adopted to identify factors influencing respondents' perceptions. Semistructured interviews are used to identify the reasons why some respondents believed the URRBMI to be ineffective.
Results: Overall, 77.5% of respondents believe that the URRBMI is effective. Respondents, who are older, have a higher household income, prefer primary health facilities and provide a higher rating for critical illness compensation and maximum compensatory payouts. They are more likely to give the URRBMI a higher effectiveness rating than their counterparts. Qualitatively, participants who believe the URRBMI to be ineffective list the following reasons: low outpatient service coverage, insufficient or undersupplied drugs and services in the insurance list, problems in the arrangement of deductibles and maximum compensatory payouts, provider-induced behaviour and increased healthcare service price.
Conclusions: This exploration focuses on the reasons why rural residents think the scheme is invalid, which are vital for policy reform. Policies should focus on benefits design and coverage, the assumption of a supervisory role, avoiding financial risk stemming from critical illness and cross-sectoral actions to strengthen the primary healthcare system and comprehensive social security wealth.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

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