Table 1. Description of variables.
Variables
|
Description
|
Household expenditure (CNT)
|
Total consumption expenditure of a household.
|
OOP medical expenditure (CNY)
|
Total out-of-pocket medical expenditure of a household.
|
Food expenditure (CNY)
|
Total food consumption expenditure of a household.
|
Economic status (CNY)
|
The annual household income per capita.
|
Household size
|
The number of household members.
|
Inpatient
|
At least one household member received inpatient services in last year; Yes=1; No=0a.
|
Household members aged<=5
|
At least one household member below 5 years old; Yes=1; No=0a.
|
Household members aged>=60
|
At least one household member over 60 years old; Yes=1; No=0a.
|
Basic medical insurance
|
At least one household member covered by basic medical insurance; Yes=1; No=0a.
|
SMI
|
At least one household member covered by SMI; Yes=1; No=0a.
|
Geographic location
|
East=1a; Central=2; West=3.
|
Gender of household head
|
Female=0a; Male=1.
|
Education of household head
|
Illiterate=1a; Primary school=2; Middle school=3; High school and above=4.
|
Marriage of household head
|
Married=1; Unmarried=0a.
|
Self-assessed health status of household head
|
Excellent=1a; Very good=2; Good=3; Fair=4; Poor=5.
|
Note: a Reference group; OOP = Out-of-pocket medical expenditure; SMI Supplementary medical insurance.
Table 2. Summary statistics of variables.
Variables
|
2012
|
|
2016
|
Urban areas
|
|
Rural areas
|
Urban areas
|
|
Rural areas
|
Mean(N)
|
Std. Err. (%)
|
Mean(N)
|
Std. Err. (%)
|
Mean(N)
|
Std. Err. (%)
|
|
Mean(N)
|
Std. Err. (%)
|
Household expenditure (CNY)
|
52035.58
|
2023.35
|
|
32184.74
|
879.58
|
|
74801.23
|
2894.11
|
|
43930.66
|
1122.37
|
OOP medical expenditure (CNY)
|
6107.66
|
438.43
|
|
4927.91
|
290.80
|
|
9081.93
|
514.19
|
|
7370.13
|
349.82
|
Food household expenditure (CNY)
|
17636.04
|
413.47
|
|
12972.67
|
297.14
|
|
23292.19
|
396.39
|
|
11612.57
|
273.27
|
Economic status (CNY)
|
18513.86
|
632.62
|
|
9538.07
|
354.71
|
|
29905.45
|
1416.38
|
|
16110.23
|
2256.36
|
Household size
|
3.63
|
0.04
|
|
4.28
|
0.05
|
|
3.69
|
0.04
|
|
4.27
|
0.04
|
Inpatient
|
|
|
|
|
|
|
|
|
|
|
|
Yes
|
495
|
36.72
|
|
562
|
36.90
|
|
896
|
45.21
|
|
976
|
46.86
|
No1
|
853
|
63.28
|
|
961
|
63.10
|
|
1086
|
54.79
|
|
1107
|
53.14
|
Household members aged<=5
|
|
|
|
|
|
|
|
|
|
|
|
Yes
|
214
|
15.88
|
|
360
|
23.64
|
|
318
|
16.04
|
|
455
|
21.84
|
No1
|
1134
|
84.12
|
|
1163
|
76.36
|
|
1664
|
83.96
|
|
1628
|
78.16
|
Household members aged>=60
|
|
|
|
|
|
|
|
|
|
|
|
Yes
|
657
|
48.74
|
|
778
|
51.08
|
|
1171
|
59.08
|
|
1235
|
59.29
|
No1
|
691
|
51.26
|
|
745
|
48.92
|
|
811
|
40.92
|
|
848
|
40.71
|
Basic medical insurance
|
|
|
|
|
|
|
|
|
|
|
|
Yes
|
1206
|
89.47
|
|
1483
|
97.37
|
|
1882
|
94.95
|
|
2047
|
98.27
|
No1
|
142
|
10.53
|
|
40
|
2.63
|
|
100
|
5.05
|
|
36
|
1.73
|
SMI
|
|
|
|
|
|
|
|
|
|
|
|
Yes
|
37
|
2.74
|
|
22
|
1.44
|
|
115
|
5.80
|
|
61
|
2.93
|
No1
|
1311
|
97.26
|
|
1501
|
98.56
|
|
1867
|
94.20
|
|
2022
|
97.07
|
Geographic location
|
|
|
|
|
|
|
|
|
|
|
|
East1
|
720
|
53.41
|
|
518
|
34.01
|
|
885
|
44.65
|
|
641
|
30.77
|
Central
|
423
|
31.38
|
|
462
|
30.33
|
|
697
|
35.17
|
|
668
|
32.07
|
West
|
205
|
15.21
|
|
543
|
35.65
|
|
400
|
20.18
|
|
774
|
37.16
|
Gender of household head
|
|
|
|
|
|
|
|
|
|
|
|
Female1
|
712
|
52.82
|
|
585
|
38.41
|
|
1045
|
52.72
|
|
924
|
44.36
|
Male
|
636
|
47.18
|
|
938
|
61.59
|
|
937
|
47.28
|
|
1159
|
55.64
|
Education of household head
|
|
|
|
|
|
|
|
|
|
|
|
Illiterate1
|
266
|
19.73
|
|
586
|
38.48
|
|
403
|
20.33
|
|
766
|
36.77
|
Primary school
|
245
|
18.18
|
|
412
|
27.05
|
|
405
|
20.43
|
|
589
|
28.28
|
Middle school
|
388
|
28.78
|
|
368
|
24.16
|
|
563
|
28.41
|
|
500
|
24.00
|
High school and above
|
449
|
33.31
|
|
157
|
10.31
|
|
611
|
30.83
|
|
228
|
10.95
|
Marriage of household head
|
|
|
|
|
|
|
|
|
|
|
|
Married
|
1204
|
89.32
|
|
1390
|
91.27
|
|
1710
|
86.28
|
|
1836
|
88.14
|
Unmarried1
|
144
|
10.68
|
|
133
|
8.73
|
|
272
|
13.72
|
|
247
|
11.86
|
Self-assessed health status of household head
|
|
|
|
|
|
|
|
|
|
|
|
Excellent1
|
49
|
3.64
|
|
64
|
4.20
|
|
111
|
5.60
|
|
128
|
6.14
|
Very good
|
107
|
7.94
|
|
153
|
10.05
|
|
158
|
7.97
|
|
195
|
9.36
|
Good
|
446
|
33.09
|
|
473
|
31.06
|
|
698
|
35.22
|
|
606
|
29.09
|
Fair
|
350
|
25.96
|
|
316
|
20.75
|
|
476
|
24.02
|
|
439
|
21.08
|
Poor
|
396
|
29.38
|
|
517
|
33.95
|
|
539
|
27.19
|
|
715
|
34.33
|
Observations
|
1348
|
100.00
|
|
1523
|
100.00
|
|
1982
|
100%
|
|
2083
|
100%
|
Note: 1 Reference group; OOP out-of-pocket; SMI Supplementary medical insurance.
Table 3. CHE incidence and intensity in rural and urban households with NCD patients.
|
2012
|
|
2016
|
Incidence
|
Overshoot
|
MPO
|
Incidence
|
Overshoot
|
MPO
|
Urban areas
|
19.44%
|
4.19%
|
21.55%
|
|
19.88%
|
4.39%
|
22.08%
|
Rural areas
|
27.38%
|
6.36%
|
23.23%
|
|
26.02%
|
6.17%
|
23.71%
|
Note: CHE catastrophic health expenditure; MPO mean positive overshoot.
Table 4. Association between factors and CHE incidence in rural and urban households with NCD patients.
Variables
|
2012
|
|
2016
|
Urban areas
|
|
Rural areas
|
Urban areas
|
|
Rural areas
|
dy/dx
|
Std. Err.
|
dy/dx
|
Std. Err.
|
dy/dx
|
Std. Err.
|
dy/dx
|
Std. Err.
|
Economic status
|
-0.0417**
|
0.0080
|
|
-0.0103
|
0.0089
|
|
-0.0349**
|
0.0091
|
|
-0.0241**
|
0.0094
|
Household size
|
-0.0280**
|
0.0071
|
|
-0.0458**
|
0.0065
|
|
-0.0356**
|
0.0055
|
|
-0.0433**
|
0.0053
|
Inpatient, yes
|
0.1798**
|
0.0184
|
|
0.2044**
|
0.0202
|
|
0.1712**
|
0.0161
|
|
0.1958**
|
0.0168
|
Household members aged<=5, yes
|
0.0154
|
0.0321
|
|
0.0103
|
0.0295
|
|
-0.0052
|
0.0275
|
|
0.0393
|
0.0255
|
Household members aged>=60, yes
|
0.0680**
|
0.0204
|
|
0.0869**
|
0.0223
|
|
0.0494**
|
0.0182
|
|
0.0760**
|
0.0191
|
Basic medical insurance, yes
|
0.0340
|
0.0329
|
|
0.0578
|
0.0674
|
|
0.0015
|
0.0368
|
|
0.0048
|
0.0639
|
SMI, yes
|
0.0319
|
0.0607
|
|
-0.0559
|
0.1025
|
|
-0.0680
|
0.0436
|
|
-0.0689
|
0.0592
|
Geographic location
|
|
|
|
|
|
|
|
|
|
|
|
East1
|
|
|
|
|
|
|
|
|
|
|
|
Central
|
0.0112
|
0.0221
|
|
0.0143
|
0.0258
|
|
-0.0097
|
0.0193
|
|
-0.0547**
|
0.0221
|
West
|
-0.0105
|
0.0285
|
|
-0.0697**
|
0.0262
|
|
-0.0017
|
0.0227
|
|
-0.0719**
|
0.0221
|
Gender of household head, male
|
0.0368
|
0.0196
|
|
0.0091
|
0.0224
|
|
-0.0096
|
0.0168
|
|
0.0391*
|
0.0186
|
Education of household head
|
|
|
|
|
|
|
|
|
|
|
|
Illiterate1
|
|
|
|
|
|
|
|
|
|
|
|
Primary school
|
-0.0722*
|
0.0293
|
|
-0.0495
|
0.0262
|
|
-0.0534*
|
0.0238
|
|
-0.0211
|
0.0225
|
Middle school
|
-0.1104**
|
0.0272
|
|
-0.0677*
|
0.0285
|
|
-0.0751**
|
0.0232
|
|
-0.0610*
|
0.0249
|
High school and above
|
-0.0970**
|
0.0279
|
|
-0.1052*
|
0.0418
|
|
-0.1293**
|
0.0249
|
|
-0.0446
|
0.0332
|
Marriage of household head, married
|
0.0270
|
0.0317
|
|
-0.0538
|
0.0361
|
|
-0.0299
|
0.0233
|
|
0.0294
|
0.0280
|
Self-assessed health status of household head
|
|
|
|
|
|
|
|
|
|
|
|
Excellent1
|
|
|
|
|
|
|
|
|
|
|
|
Very good
|
0.0395
|
0.0808
|
|
-0.0208
|
0.0611
|
|
-0.0376
|
0.0479
|
|
0.0432
|
0.0482
|
Good
|
0.0942
|
0.0716
|
|
-0.0204
|
0.0538
|
|
-0.0489
|
0.0393
|
|
0.0143
|
0.0414
|
Fair
|
0.1234
|
0.0720
|
|
-0.0369
|
0.0557
|
|
0.0054
|
0.0398
|
|
0.0080
|
0.0425
|
Poor
|
0.2040**
|
0.0709
|
|
0.0846
|
0.0532
|
|
0.0426
|
0.0391
|
|
0.1370**
|
0.0399
|
Note: 1 Reference group; SMI Supplementary medical insurance; The dy/dx in brackets indicates the marginal effect; * p < 0.05; ** p < 0.01.
Table 5. Association between factors and CHE intensity in rural and urban households with NCD patients.
Variables
|
2012
|
|
2016
|
Urban areas
|
|
Rural areas
|
Urban areas
|
|
Rural areas
|
dy/dx
|
Std. Err.
|
dy/dx
|
Std. Err.
|
dy/dx
|
Std. Err.
|
dy/dx
|
Std. Err.
|
Economic status
|
-0.0133**
|
0.0026
|
|
-0.0086**
|
0.0028
|
|
-0.0125**
|
0.0028
|
|
-0.0095**
|
0.0030
|
Household size
|
-0.0100**
|
0.0021
|
|
-0.0137**
|
0.0020
|
|
-0.0110**
|
0.0016
|
|
-0.0109**
|
0.0016
|
Inpatient, yes
|
0.0525**
|
0.0059
|
|
0.0607**
|
0.0067
|
|
0.0461**
|
0.0050
|
|
0.0567**
|
0.0056
|
Household members aged<=5, yes
|
0.0005
|
0.0088
|
|
-0.0100
|
0.0087
|
|
0.0035
|
0.0075
|
|
0.0027
|
0.0076
|
Household members aged>=60, yes
|
0.0188**
|
0.0059
|
|
0.0275**
|
0.0068
|
|
0.0144**
|
0.0052
|
|
0.0172**
|
0.0058
|
Basic medical insurance, yes
|
0.0171
|
0.0093
|
|
0.0177
|
0.0198
|
|
-0.0059
|
0.0114
|
|
0.0139
|
0.0210
|
SMI, yes
|
0.0093
|
0.0170
|
|
0.0311
|
0.0264
|
|
-0.0092
|
0.0104
|
|
-0.0198
|
0.0162
|
Geographic location
|
|
|
|
|
|
|
|
|
|
|
|
East1
|
|
|
|
|
|
|
|
|
|
|
|
Central
|
0.0027
|
0.0064
|
|
-0.0013
|
0.0079
|
|
-0.0042
|
0.0056
|
|
-0.0176**
|
0.0069
|
West
|
-0.0041
|
0.0082
|
|
-0.0291**
|
0.0078
|
|
-0.0046
|
0.0068
|
|
-0.0238**
|
0.0069
|
Gender of household head, male
|
0.0119*
|
0.0057
|
|
0.0091
|
0.0067
|
|
0.0041
|
0.0049
|
|
0.0088
|
0.0057
|
Education of household head
|
|
|
|
|
|
|
|
|
|
|
|
Illiterate1
|
|
|
|
|
|
|
|
|
|
|
|
Primary school
|
-0.0248**
|
0.0091
|
|
-0.0092
|
0.0081
|
|
-0.0286**
|
0.0077
|
|
-0.0097
|
0.0070
|
Middle school
|
-0.0324**
|
0.0084
|
|
-0.0126
|
0.0086
|
|
-0.0249**
|
0.0073
|
|
-0.0177*
|
0.0076
|
High school and above
|
-0.0263**
|
0.0085
|
|
-0.0183
|
0.0118
|
|
-0.0387**
|
0.0076
|
|
-0.0097
|
0.0099
|
Marriage of household head, married
|
0.0043
|
0.0093
|
|
-0.0127
|
0.0115
|
|
0.0029
|
0.0074
|
|
-0.0008
|
0.0088
|
Self-assessed health status of household head
|
|
|
|
|
|
|
|
|
|
|
|
Excellent1
|
|
|
|
|
|
|
|
|
|
|
|
Very good
|
-0.0083
|
0.0175
|
|
0.0009
|
0.0182
|
|
-0.0087
|
0.0133
|
|
0.0126
|
0.0141
|
Good
|
-0.0038
|
0.0153
|
|
0.0022
|
0.0163
|
|
-0.0144
|
0.0111
|
|
-0.0019
|
0.0121
|
Fair
|
0.0029
|
0.0156
|
|
-0.0022
|
0.0168
|
|
-0.0084
|
0.0114
|
|
0.0040
|
0.0125
|
Poor
|
0.0247
|
0.0156
|
|
0.0394*
|
0.0164
|
|
0.0166
|
0.0114
|
|
0.0408**
|
0.0120
|
Note: 1 Reference group; SMI Supplementary medical insurance; The dy/dx in brackets indicates the marginal effect; * p < 0.05; ** p < 0.01.
Table 6. Aggregate decomposition of the urban-rural differences in CHE incidence and intensity among households with NCD patients.
|
Total differences
|
|
Explained part
|
|
Unexplained part
|
Coefficient
|
Percent
|
Coefficient
|
Percent
|
Coefficient
|
Percent
|
2012
|
CHE incidence
|
0.0794
|
100.00
|
|
0.0025
|
3.15
|
|
0.0769
|
96.85
|
|
CHE intensity
|
0.0216
|
100.00
|
|
0.0046
|
21.30
|
|
0.0170
|
78.70
|
2016
|
CHE incidence
|
0.0614
|
100.00
|
|
0.0166
|
27.04
|
|
0.0448
|
72.96
|
|
CHE intensity
|
0.0178
|
100.00
|
|
0.0095
|
53.37
|
|
0.0083
|
46.63
|
Table 7. Detailed decomposition of the urban-rural differences in CHE incidence among households with NCD patients.
Variables
|
2012
|
|
2016
|
Explained part
|
Percent
(%)
|
Explained part
|
Percent
(%)
|
Economic status
|
0.0075
|
9.45
|
|
0.0183**
|
29.80
|
Household size
|
-0.0250**
|
-31.49
|
|
-0.0204**
|
-33.22
|
Inpatient, yes
|
-0.0019
|
-2.39
|
|
0.0012
|
1.95
|
Household members aged<=5, yes
|
0.0008
|
1.01
|
|
0.0018
|
2.93
|
Household members aged>=60, yes
|
0.0014
|
1.76
|
|
0.0001
|
0.16
|
Basic medical insurance, yes
|
0.0043
|
5.42
|
|
0.0002
|
0.33
|
SMI, yes
|
0.0006
|
0.76
|
|
0.0013
|
2.12
|
Geographic location
|
|
|
|
|
|
East1
|
|
|
|
|
|
Central
|
-0.0001
|
-0.13
|
|
0.0014
|
2.28
|
West
|
-0.0135**
|
-17.00
|
|
-0.0115**
|
-18.73
|
Gender of household head, male
|
0.0013
|
1.64
|
|
0.0029*
|
4.72
|
Education of household head
|
|
0.00
|
|
|
|
Illiterate1
|
|
0.00
|
|
|
|
Primary school
|
-0.0039
|
-4.91
|
|
-0.0014
|
-2.28
|
Middle school
|
0.0046*
|
5.79
|
|
0.0034*
|
5.54
|
High school and above
|
0.0218**
|
27.46
|
|
0.0081
|
13.19
|
Marriage of household head, married
|
-0.0012
|
-1.51
|
|
0.0005
|
0.81
|
Self-assessed health status of household head
|
|
|
|
|
|
Excellent1
|
|
|
|
|
|
Very good
|
-0.0004
|
-0.50
|
|
0.0003
|
0.49
|
Good
|
0.0004
|
0.50
|
|
-0.0010
|
-1.63
|
Fair
|
0.0019
|
2.39
|
|
-0.0003
|
-0.49
|
Poor
|
0.0040
|
5.04
|
|
0.0117**
|
19.06
|
Note: 1 Reference group; SMI Supplementary medical insurance; * p < 0.05; ** p < 0.01.
Table 8. Detailed decomposition of the urban-rural differences in CHE intensity among households with NCD patients.
Variables
|
2012
|
|
2016
|
Explained part
|
Percent
(%)
|
Unexplained part
|
Percent
(%)
|
Explained part
|
Percent
(%)
|
Unexplained part
|
Percent
(%)
|
Economic status
|
0.0080**
|
36.90
|
0.0415
|
192.13
|
|
0.0084**
|
47.19
|
0.0274
|
153.93
|
Household size
|
-0.0080**
|
-37.08
|
-0.0142
|
-65.74
|
|
-0.0062**
|
-34.78
|
0.0002
|
1.18
|
Inpatient, yes
|
0.0001
|
0.47
|
0.0030
|
13.94
|
|
0.0009
|
4.81
|
0.0048
|
27.19
|
Household members aged<=5, yes
|
-0.0004
|
-2.03
|
-0.0020
|
-9.21
|
|
0.0002
|
1.06
|
-0.0002
|
-0.86
|
Household members aged>=60, yes
|
0.0005
|
2.47
|
0.0043
|
20.05
|
|
0.0000
|
0.18
|
0.0017
|
9.44
|
Basic medical insurance, yes
|
0.0016
|
7.50
|
0.0004
|
1.79
|
|
0.0001
|
0.36
|
0.0192
|
107.87
|
SMI, yes
|
-0.0002
|
-1.00
|
0.0004
|
1.91
|
|
0.0004*
|
2.27
|
-0.0005
|
-2.53
|
Geographic location
|
|
|
|
|
|
|
|
|
|
East1
|
|
|
|
|
|
|
|
|
|
Central
|
0.0000
|
-0.09
|
-0.0012
|
-5.65
|
|
0.0003
|
1.71
|
-0.0045
|
-25.06
|
West
|
-0.0041**
|
-18.75
|
-0.0057*
|
-26.39
|
|
-0.0025**
|
-13.82
|
-0.0054*
|
-30.56
|
Gender of household head, male
|
0.0015*
|
6.76
|
-0.0015
|
-6.85
|
|
0.0006
|
3.10
|
0.0024
|
13.31
|
Education of household head
|
|
|
|
|
|
|
|
|
|
Illiterate1
|
|
|
|
|
|
|
|
|
|
Primary school
|
-0.0013*
|
-5.97
|
0.0033
|
15.28
|
|
-0.0013**
|
-7.25
|
0.0044
|
24.66
|
Middle school
|
0.0010*
|
4.46
|
0.0053
|
24.63
|
|
0.0008*
|
4.72
|
0.0020
|
11.12
|
High school and above
|
0.0047**
|
21.62
|
0.0022
|
10.14
|
|
0.0051**
|
28.54
|
0.0058*
|
32.47
|
Marriage of household head, married
|
-0.0001
|
-0.24
|
-0.0154
|
-71.30
|
|
0.0000
|
0.11
|
-0.0032
|
-18.15
|
Self-assessed health status of household head
|
|
|
|
|
|
|
|
|
|
Excellent1
|
|
|
|
|
|
|
|
|
|
Very good
|
-0.0001
|
-0.41
|
0.0008
|
3.87
|
|
0.0000
|
0.14
|
0.0019
|
10.39
|
Good
|
0.0000
|
0.09
|
0.0019
|
8.80
|
|
0.0005
|
2.63
|
0.0041
|
22.87
|
Fair
|
0.0000
|
0.00
|
-0.0012
|
-5.51
|
|
0.0001
|
0.33
|
0.0028
|
15.73
|
Poor
|
0.0014*
|
6.62
|
0.0047
|
21.67
|
|
0.0021**
|
11.91
|
0.0074
|
41.46
|
Constant
|
|
|
-0.0096
|
-44.44
|
|
|
|
-0.0619
|
-347.75
|
Note: 1 Reference group; SMI Supplementary medical insurance; * p < 0.05; ** p < 0.01.