Understanding Inequality in Elderly Well-being in China and the UK

• Start date: 01 September 2011
• End date: 31 August 2012

The primary goals of the project are to evaluate the impact of the New Cooperative Medical Scheme (NCMS) and provider payment incentives on affordable access to care and financial risk protection. The study adopted a quasi-experimental design that allowed rigorous impact evaluations to be done. Based on household data from 2009 and 2011, for a sample of 35,000 individuals in 7000 households in five counties in a poor province in the north western region of China, the project found that NCMS improved utilization of health care services, especially at the village level. Although out of pocket spending has been reduced, the change was not statistically significant. Preliminary findings comparing providers paid by fee-for-service vs. capitation show that capitation payment method resulted in lowered expenditure per visit, increased use of services at village clinics (as opposed to higher-level facilities), reduced intravenous injection and antibiotic prescriptions. In the following year, analyses will be conducted to examine the relative effects of price and quality on patients’ choice of providers and the consequences on access and out of pocket spending.