Progress on Catastrophic Health Expenditure in China: Evidence from China Family Panel Studies (CFPS) 2010 to 2016

Ma, Xiaochen; Wang, Ziyue; Liu, Xiaoyun

doi:10.3390/ijerph16234775

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Progress on Catastrophic Health Expenditure in China: Evidence from China Family Panel Studies (CFPS) 2010 to 2016

Xiaochen Ma

^1,†,

Ziyue Wang

^1,2,† and

Xiaoyun Liu

^1,*

China Center for Health Development Studies, Peking University, Beijing 100191, China

Department of Health Policy and Management, School of Public Health, Peking University, Beijing 100191, China

Author to whom correspondence should be addressed.

^†

These authors contributed equally and are co-first authors.

Int. J. Environ. Res. Public Health 2019, 16(23), 4775; https://doi.org/10.3390/ijerph16234775

Received: 8 November 2019 / Revised: 22 November 2019 / Accepted: 26 November 2019 / Published: 28 November 2019

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Abstract

Background: To provide an updated estimate of the level and change in catastrophic health expenditure in China and examine the association between catastrophic health expenditure and family net income, we obtained data from four waves of the China Family Panel Studies conducted between 2010 and 2016. Method: We defined catastrophic health expenditure as out-of-pocket payments equaling or exceeding 40% of the household’s capacity to pay. The Poisson regression with robust variance and generalized estimated equation (Poisson-GEE) model was used to quantify the level and change of catastrophic health expenditure, as well as the association between catastrophic heath expenditure and family net income. Result: Overall, the incidence of catastrophic expenditure in China experienced a 0.70-fold change between 2010 (12.57%) and 2016 (8.94%). The incidence of catastrophic health expenditure (CHE) decreased more in the poorest income quintile than the richest income quintile (annual decrease of 1.17% vs. 0.24% in urban areas, p < 0.001; 1.64% vs. −0.02% in rural areas, p < 0.001). Every 100% increase in income was associated with a 14% relative-risk reduction in CHE (RR = 0.86, 95% CI: 0.85–0.88) after adjusting for demographics, health needs, and health utilization characteristics; this association was weaker in recent years. Conclusion: Our analysis found that China made progress to reduce catastrophic health expenditure, especially for poorer groups. Income growth is strongly associated with this change. View Full-Text

Keywords: catastrophic health expenditure; inequity; health care expenditures; income; China

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Ma, X.; Wang, Z.; Liu, X. Progress on Catastrophic Health Expenditure in China: Evidence from China Family Panel Studies (CFPS) 2010 to 2016. Int. J. Environ. Res. Public Health 2019, 16, 4775. https://doi.org/10.3390/ijerph16234775

AMA Style

Ma X, Wang Z, Liu X. Progress on Catastrophic Health Expenditure in China: Evidence from China Family Panel Studies (CFPS) 2010 to 2016. International Journal of Environmental Research and Public Health. 2019; 16(23):4775. https://doi.org/10.3390/ijerph16234775

Chicago/Turabian Style

Ma, Xiaochen, Ziyue Wang, and Xiaoyun Liu. 2019. "Progress on Catastrophic Health Expenditure in China: Evidence from China Family Panel Studies (CFPS) 2010 to 2016" International Journal of Environmental Research and Public Health 16, no. 23: 4775. https://doi.org/10.3390/ijerph16234775

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Progress on Catastrophic Health Expenditure in China: Evidence from China Family Panel Studies (CFPS) 2010 to 2016

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