China's rural residents still under pressure from high medical expenses - report
By Karl Zhong
Shanghai. August 4. INTERFAX-CHINA - Rural residents in China are still under pressure from high medical expenses despite the introduction of the new rural cooperative insurance program several years ago, according to a recently released research report.
The report is based on a survey conducted by Peking University's China Center for Pharmaceutical Economic Research from December 2007 to May 2008 in Beijing, Xi'an, Chengdu and Kunming cities. A total of 12,691 persons from 4,411 households were surveyed.
Medical expenses, covering both inpatient and outpatient treatment, accounted for over 50 percent of total expenditures of rural households, the report said.
With regards to inpatient medical treatment expenses, rural residents received reimbursements averaging RMB 201.97 ($29.57), against RMB 411.38 ($60.23) for urban residents. The proportion of reimbursed inpatient medical treatment expenses over total inpatient medical treatment expenses incurred stood at 22.27 percent and 53.01 percent in rural and urban areas respectively.
According to the report, average inpatient medical treatment expenses incurred by rural residents grew to RMB 5,106 ($747.58) when compared with RMB 3,066 ($448.90) noted in the Ministry of Health's (MoH) fourth national health service survey conducted in 2003, up 66.54 percent, while average inpatient medical treatment expenses incurred by urban residents hit RMB 10,101 ($1,478), up 7.59 percent from RMB 9,388 ($1,374) in 2003.
Likewise, average outpatient treatment expenses incurred by rural residents rose to RMB 253.9 ($37.17), more than 100 percent from RMB 121.0 ($17.72) in 2003. Average outpatient treatment expenses incurred by urban residents rose to RMB 382.2 ($55.96), up over 50 percent from RMB 278.0 ($40.70) in 2003.
In addition, the prevalence of chronic diseases in rural areas has also significantly increased since the fourth national health service survey in 2003, with hypertension and diabetes remaining as the two most common chronic diseases in China. Recent MoH statistics showed that there were 73 million hypertension patients and 14 million diabetes patients in China in 2008.
The survey by the China Center for Pharmaceutical Economic Research found that hypertension prevalence increased by 50 percent and 100 percent in urban and rural areas respectively since 2003 while diabetes prevalence jumped by two-thirds and four times in urban and rural areas respectively.
Two factors, namely changes in disease spectrum in rural areas as well as increased hospital visits, can be attributed to the growth in chronic disease prevalence, the report said.
The report proposed that the Chinese government place more attention on the health situation in rural areas and increase investment into a sound medical care infrastructure in rural areas by extending new rural cooperative medical insurance coverage, improving medical treatment quality offered by rural doctors and attracting more private medical investments to rural areas.
"While it is encouraging to see that the Chinese government is increasing rural investments by upgrading facilities in township clinics and county hospitals and attracting medical college graduates to work in rural areas, the gap between urban and rural areas will likely exist as long as economic development in urban and rural areas continues in a disproportionate manner," a Beijing-based pharmaceutical analyst, who wished to be anonymous, told Interfax.
According to the report, health education will be vital in chronic disease prevention in rural areas as residents who participated in at least one to two health education programs recorded a 10.48 percent disease incidence rate over a two-week period, as compared with 12.79 percent among residents who did not. Further, only 21.28 percent of rural residents understood the importance of health education against 42.63 percent among urban residents.
The report also suggests that the government should fund health education initiatives and help Chinese residents develop an understanding towards health science and the importance of adopting a healthy lifestyle.
Dr. Hans Troedsson, World Health Organization's chief representative in China, told Interfax earlier in May this year that unhealthy lifestyle is one of the biggest challenges China faces in carrying out its health care reform.