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The Effects of Social Health Insurance Reform on People's Out-of-Pocket Health Expenditure in China - The Mediating Role of the Institutional Arrangement (Paperback, Softcover reprint of the original 1st ed. 2016)
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The Effects of Social Health Insurance Reform on People's Out-of-Pocket Health Expenditure in China - The Mediating Role of the Institutional Arrangement (Paperback, Softcover reprint of the original 1st ed. 2016)
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This study examines and explains the relationship between social
health insurance (SHI) participation and out-of-pocket expenditures
(OOP) as well as the mediating role the institutional arrangement
of SHI plays in this relationship in China. Embracing a new
institutionalist approach, it develops two analytical perspectives:
determination, which identifies the mechanisms of social health
insurance, and strategic interaction, which explores the
interaction among social health insurance agencies, healthcare
providers, patients, and institutions. It reveals the poor
performance of social health insurance in decreasing out-of-pocket
health expenditures caused by a trade-off between the
reimbursement, behavior management, and purchasing mechanisms of
social health insurance programs. Further, it finds that the
inequitable allocation of healthcare resources and patients'
concerns regarding the benefits offset the strategies used by
social health insurance agencies to manage care-seeking behavior.
It also discovers that the complex interactions between insurance
agencies, doctors, patients and a larger disenabling institutional
surrounding restricts the purchasing efficiency of social health
insurance. This book is characterized by its unique synthesis of
the role of the institutional arrangement of social health
insurance in China, the interaction between the stakeholders in
health sectors, and of the relationship between healthcare
institutions, actors, and policy outcomes. Providing a
comprehensive overview, it enables scholars and graduate students
to understand the ongoing process of social health insurance reform
as well as the dynamics of health cost inflation in China. It also
benefits policymakers by recommending a single-payer model based on
an evidence-based investigation.
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