Case study of the beneficiary group distribution of curative care expenditure based on SHA 2011 in Xinjiang autonomous region, China

BMJ Open. 2021 Jun 28;11(6):e043155. doi: 10.1136/bmjopen-2020-043155.

Abstract

Background: The System of Health Accounts 2011 (SHA 2011) assists in health policy analysis and health expenditure comparison at the international level. Based on SHA 2011, this study analysed the distribution of beneficiary groups of curative care expenditure (CCE) in Xinjiang, to present suggestions for developing health policies.

Methods: A total of 160 health institutions were selected using the multistage stratified random sampling method. An analysis of the agewise CCE distribution, institutional flow, and disease distribution was then performed based on the SHA 2011 accounting framework.

Results: In 2016, the CCE in Xinjiang was ¥50.05 billion, accounting for 70.18% of current health expenditure and 6.66% of the gross domestic product. The per capita CCE was ¥2366.56. The CCE was distributed differently across age groups, with the highest spending on people over the age of 65 years. The CCE was highest for diseases of the circulatory, respiratory and digestive systems. Most of the expenditure was incurred in hospitals and, to a lesser extent, in primary healthcare institutions. Family health expenditure, especially on children aged 14 years and below, accounted for a relatively high proportion of the CCE.

Conclusion: SHA 2011 was used to capture data, which was then analysed according to the newly added beneficiary dimension. The findings revealed that the use of medical resources is low, the scale of primary medical institutions needs to be significantly expanded and there is a need to optimise the CCE financing scheme. Therefore, the health policymaking department should optimise the relevant policies and improve the efficiency of health services.

Keywords: health economics; health policy; public health.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Child
  • China
  • Gross Domestic Product
  • Health Expenditures*
  • Health Policy*
  • Hospitals
  • Humans