Abstract
Aim
The implementation of the Chinese New Rural Cooperative Medical Scheme (NRCMS) spread fast since a county pilot trial in 2003. The purpose of this survey is to guide policy-makers on how to improve the current national NRCMS policy.
Subject and methods
Cross-sectional survey of 1,978 farmers in 50 villages in Huxian Shaanxi Province on their attitudes towards the NRCMS administered door-to-door in 2005.
Results
Most farmers hold a positive attitude towards the NRCMS. However, they do not trust the scheme management. Farmers place more trust in village doctors rather than village cadres for fund collection. More than two thirds of farmers seek care in county hospitals directly, bypassing village clinics and township hospitals. Not all hospitals and doctors fully comply with the NRCMS rules, and supplier-induced demand is still widespread. More than half of farmers worry that the NRCMS is not sustainable. Importantly, the survey showed a high enrolment rate of 92% (95% CI, 91; 93) in a voluntary insurance scheme.
Conclusion
A number of remedial actions in health financing, planning and management to counteract the identified issues are proposed.
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Acknowledgements
We would like to thank the staff from the NRCMS Office in Huxian and the Statistical Bureau of Huxian for their contribution to the survey and provision of statistical data. Support from the National Institute for Health Research (NIHR) in England for CAG's contribution is also gratefully acknowledged. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health in England.
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The authors declare that they have no conflict of interest.
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Xu, C., Wang, Z. & Gericke, C.A. The attitude of farmers to the New Rural Cooperative Medical Scheme in Northwest China one year after its introduction: a cross-sectional study. J Public Health 20, 235–243 (2012). https://doi.org/10.1007/s10389-011-0448-9
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DOI: https://doi.org/10.1007/s10389-011-0448-9