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The Dilemma of Medical Reimbursement Policy in Rural China: Spatial Variability between Reimbursement Region and Medical Catchment Area

1,2, 1,2, 1,2,* and 1,2
1
College of Management and Economics, Tianjin University, Tianjin 300072, China
2
Center for Social Science Survey and Data, Tianjin University, Tianjin 300072, China
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(16), 2867; https://doi.org/10.3390/ijerph16162867
Received: 31 May 2019 / Revised: 28 July 2019 / Accepted: 7 August 2019 / Published: 10 August 2019
(This article belongs to the Special Issue Rural Health Care)
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PDF [3163 KB, uploaded 10 August 2019]
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Abstract

Since the initiation of the New Rural Cooperative Medical Scheme (NCMS) in 2003 in China, medical reimbursement plays an increasingly important role in reducing the familial burden of critical illness healthcare in rural China. However, the current medical reimbursement system is operated based on prefecture-level administrative boundaries, which may prevent some residents from accessing higher-quality medical resources. Using a reliable and high-accuracy geographic information system (GIS) dataset, this study investigates whether this reimbursement system restricts rural residents from freely seeking out medical services in the Hubei Province by employing a two-step floating catchment area (2SFCA). Results show that there are spatial differences between the catchment area of different graded medical centers and prefecture-level administrative boundaries. Spatial reimbursement boundaries should be readjusted so that most rural residents receive equitable coverage by the system and reimburse their medical expenses in a more convenient way. Therefore, we argue that the local government should delineate the spatial region of the medical reimbursement for rural residents according to an assessment of their spatial accessibility to different graded medical centers beyond prefecture-level boundaries. We also discuss potential methods for designing reimbursement boundaries and reimbursement management strategies that the Chinese central government could adopt. View Full-Text
Keywords: Medical reimbursement; spatial accessibility; rural residents; Hubei Province Medical reimbursement; spatial accessibility; rural residents; Hubei Province
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Dong, Y.; Fu, L.; Tan, R.; Ding, L. The Dilemma of Medical Reimbursement Policy in Rural China: Spatial Variability between Reimbursement Region and Medical Catchment Area. Int. J. Environ. Res. Public Health 2019, 16, 2867.

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