, Volume 57, Issue 1, pp 193-198
Date: 19 Apr 2011

Trends of out-of-pocket expenditure for influenza in China health and nutrition survey during 1989–2006

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To examine the trends of out-of-pocket expenditure for influenza during 1989–2006 in China.


Data were extracted from the China Health and Nutrition Survey (CHNS) during 1989–2006 (in seven waves). A fixed effect model with robust standard errors was employed to examine trends of out-of-pocket expenditure (adjusted to 2006 Chinese RMB).


The out-of-pocket expenditure increased from 11.92 RMB in 1989 to 50.75 RMB in 2006. The final sample for fixed effect model was 23,050 households. Income elasticity of out-of-pocket expenditure was 1.6%. Using 1989 as reference, the predicted increase was 242.23% [95% confidence interval (CI): 225.79–259.50%] in 2006; it was 143.54% in city hospitals [95% CI: 130.43–157.40%] compared to village clinics.


Adjusted for inflation and income elasticity, Chinese households experienced an increase of more than double the out-of-pocket expenditure during 1989–2006. The expenditure was higher in higher-level facilities. Policy implications include the government fixed-budget financing to health providers could contribute to the rapidly increased financial burden; a referral system should be rebuilt; private health providers may play an important role in containing healthcare price in China.