Disparity in reimbursement for tuberculosis care among different health insurance schemes: evidence from three counties in central china

DISPARITY IN REIMBURSEMENT FOR TUBERCULOSIS CARE AMONG DIFFERENT HEALTH INSURANCE SCHEMES: EVIDENCE FROM THREE COUNTIES IN CENTRAL CHINA This study evaluates the disparity in reimbursements

for TB care among health insurance schemes CONTENTS * Abstract * Citation * Links ABSTRACT Background: The Chinese basic medical security system comprises 3 major insurance schemes - the

Urban Employee Basic Medical Insurance (UEBMI), the Urban Resident Basic Medical Insurance (URBMI), and the New Cooperative Medical Scheme (NCMS). Little research has been conducted to look

into the disparity in payments among the health insurance schemes in China. In this study, we aimed to evaluate the disparity in reimbursements for tuberculosis (TB) care among the

abovementioned health insurance schemes. Methods This study uses a World Health Organization (WHO) framework to analyze the disparities and equity relating to the three dimensions of health

insurance: population coverage, the range of services covered, and the extent to which costs are covered. Each of the health insurance scheme’s policies were categorized and analyzed. An

analysis of the claims database of all hospitalizations reimbursed from 2010 to 2012 in three counties of Yichang city (YC), which included 1506 discharges, was conducted to identify the

differences in reimbursement rates and out-of-pocket (OOP) expenses among the health insurance schemes. Results: Tuberculosis patients had various inpatient expenses depending on which

scheme they were covered by (TB patients covered by the NCMS have less inpatient expenses than those who were covered by the URBMI, who have less inpatient expenses than those covered by the

UEBMI). We found a significant horizontal inequity of healthcare utilization among the lower socioeconomic groups. In terms of financial inequity, TB patients who earned less paid more. The

NCMS provides modest financial protection, based on income. Overall, TB patients from lower socioeconomic groups were the most vulnerable. Conclusion: There are large disparities in

reimbursement for TB care among the three health insurance schemes and this, in turn, hampers TB control. Reducing the gap in health outcomes between the three health insurance schemes in

China should be a focus of TB care and control. Achieving equity through integrated policies that avoid discrimination is likely to be effective. This research is supported by the Department

for International Development’s Future Health Systems programme which is led by Johns Hopkins University CITATION Pan, Y.; Chen, S.Q.; Chen, M.L.; Zhang, P.; Long, Q.; Xiang, L.; Lucas, H.

Disparity in reimbursement for tuberculosis care among different health insurance schemes: evidence from three counties in central China. Infectious Diseases of Poverty (2016) 5 (1) 7. [DOI:

10.1186/s40249-016-0102-4] LINKS Disparity in reimbursement for tuberculosis care among different health insurance schemes: evidence from three counties in central China UPDATES TO THIS

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