Effect of basic medical insurance system on catastrophic health expenditure:a empirical study

Objective To examine changes in household catastrophic health expenditure (CHE) after the implementation of basic social medical insurance (BSMI) compensation and to explore the probability and influencing factors of household CHE.Methods An empirical data of a survey conducted in 8 provinces and municipalities in 2014 were used to estimate the incidence,the average gap and the relative gap of disastrous health expenditure among Chinese families.Logistic model was used to analyze the influencing factors of CHE.Results After the implementation of BSMI compensation,the incidence of CHE decreased by 4.870%,2.078%,and 1.706% among the families in Beijing municipality,Liaoning,and Shandong province,respectively.The proportion of mean catastrophic payment gap declined by 7.25%,5.79%,and 1.71% among families in Shanxi province,Shanxi province,and in Beijing municipality,respectively.The relative gap for CHE was 92.44%,74.25%,and 56.17% for families in Shaanxi province,Shanxi province,and Tianjin municipality,respectively.The type of medical insurance,annual household income and the actual reimbursement level of BSMI have influences on CHE.Conclusion BSMI plays a positive role in decreasing catastrophic health expenditure for families in China.