Abstract
Objectives
To examine the trends of out-of-pocket expenditure for influenza during 1989–2006 in China.
Methods
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).
Results
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.
Conclusions
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.
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Acknowledgments
This research uses data from China Health and Nutrition Survey (CHNS). We thank the National Institute of Nutrition and Food Safety, China Center for Disease Control and Prevention, Carolina Population Center, the University of North Carolina at Chapel Hill, the NIH (R01-HD30880, DK056350, and R01-HD38700) and the Fogarty International Center, NIH for financial support for the CHNS data collection and analysis files from 1989 to 2006 and both parties plus the China-Japan Friendship Hospital, Ministry of Health for support for CHNS 2009 and future surveys. We also feel grateful to anonymous reviewers for their comments and suggestions.
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The authors declare that they have no competing interests.
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Liu, J., Shi, L., Khan, M. et al. Trends of out-of-pocket expenditure for influenza in China health and nutrition survey during 1989–2006. Int J Public Health 57, 193–198 (2012). https://doi.org/10.1007/s00038-011-0251-y
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DOI: https://doi.org/10.1007/s00038-011-0251-y