The Dilemma of Medical Reimbursement Policy in Rural China: Spatial Variability between Reimbursement Region and Medical Catchment Area
Since the initiation of the New Rural Cooperative Medical Scheme (NCMS) in 2003 in China, medical reimbursement plays an increasingly important role in reducing the familial burden of critical illness healthcare in rural China. However, the current medical reimbursement system is operated based on p...
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doaj-0b01934d9cfc4fe8828c0bf8b6761b7c2020-11-25T00:55:17ZengMDPI AGInternational Journal of Environmental Research and Public Health1660-46012019-08-011616286710.3390/ijerph16162867ijerph16162867The Dilemma of Medical Reimbursement Policy in Rural China: Spatial Variability between Reimbursement Region and Medical Catchment AreaYongqing Dong0Liping Fu1Ronghui Tan2Liman Ding3College of Management and Economics, Tianjin University, Tianjin 300072, ChinaCollege of Management and Economics, Tianjin University, Tianjin 300072, ChinaCollege of Management and Economics, Tianjin University, Tianjin 300072, ChinaCollege of Management and Economics, Tianjin University, Tianjin 300072, ChinaSince the initiation of the New Rural Cooperative Medical Scheme (NCMS) in 2003 in China, medical reimbursement plays an increasingly important role in reducing the familial burden of critical illness healthcare in rural China. However, the current medical reimbursement system is operated based on prefecture-level administrative boundaries, which may prevent some residents from accessing higher-quality medical resources. Using a reliable and high-accuracy geographic information system (GIS) dataset, this study investigates whether this reimbursement system restricts rural residents from freely seeking out medical services in the Hubei Province by employing a two-step floating catchment area (2SFCA). Results show that there are spatial differences between the catchment area of different graded medical centers and prefecture-level administrative boundaries. Spatial reimbursement boundaries should be readjusted so that most rural residents receive equitable coverage by the system and reimburse their medical expenses in a more convenient way. Therefore, we argue that the local government should delineate the spatial region of the medical reimbursement for rural residents according to an assessment of their spatial accessibility to different graded medical centers beyond prefecture-level boundaries. We also discuss potential methods for designing reimbursement boundaries and reimbursement management strategies that the Chinese central government could adopt.https://www.mdpi.com/1660-4601/16/16/2867Medical reimbursementspatial accessibilityrural residentsHubei Province |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yongqing Dong Liping Fu Ronghui Tan Liman Ding |
spellingShingle |
Yongqing Dong Liping Fu Ronghui Tan Liman Ding The Dilemma of Medical Reimbursement Policy in Rural China: Spatial Variability between Reimbursement Region and Medical Catchment Area International Journal of Environmental Research and Public Health Medical reimbursement spatial accessibility rural residents Hubei Province |
author_facet |
Yongqing Dong Liping Fu Ronghui Tan Liman Ding |
author_sort |
Yongqing Dong |
title |
The Dilemma of Medical Reimbursement Policy in Rural China: Spatial Variability between Reimbursement Region and Medical Catchment Area |
title_short |
The Dilemma of Medical Reimbursement Policy in Rural China: Spatial Variability between Reimbursement Region and Medical Catchment Area |
title_full |
The Dilemma of Medical Reimbursement Policy in Rural China: Spatial Variability between Reimbursement Region and Medical Catchment Area |
title_fullStr |
The Dilemma of Medical Reimbursement Policy in Rural China: Spatial Variability between Reimbursement Region and Medical Catchment Area |
title_full_unstemmed |
The Dilemma of Medical Reimbursement Policy in Rural China: Spatial Variability between Reimbursement Region and Medical Catchment Area |
title_sort |
dilemma of medical reimbursement policy in rural china: spatial variability between reimbursement region and medical catchment area |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1660-4601 |
publishDate |
2019-08-01 |
description |
Since the initiation of the New Rural Cooperative Medical Scheme (NCMS) in 2003 in China, medical reimbursement plays an increasingly important role in reducing the familial burden of critical illness healthcare in rural China. However, the current medical reimbursement system is operated based on prefecture-level administrative boundaries, which may prevent some residents from accessing higher-quality medical resources. Using a reliable and high-accuracy geographic information system (GIS) dataset, this study investigates whether this reimbursement system restricts rural residents from freely seeking out medical services in the Hubei Province by employing a two-step floating catchment area (2SFCA). Results show that there are spatial differences between the catchment area of different graded medical centers and prefecture-level administrative boundaries. Spatial reimbursement boundaries should be readjusted so that most rural residents receive equitable coverage by the system and reimburse their medical expenses in a more convenient way. Therefore, we argue that the local government should delineate the spatial region of the medical reimbursement for rural residents according to an assessment of their spatial accessibility to different graded medical centers beyond prefecture-level boundaries. We also discuss potential methods for designing reimbursement boundaries and reimbursement management strategies that the Chinese central government could adopt. |
topic |
Medical reimbursement spatial accessibility rural residents Hubei Province |
url |
https://www.mdpi.com/1660-4601/16/16/2867 |
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