Effect of critical illness insurance on the medical expenditures of rural patients in China: an interrupted time series study for universal health insurance coverage

Objective The objective of this study is to determine if critical illness insurance (CII) promotes the universal health coverage reduce out-of-pocket (OOP) medical expenditures and improve effective reimbursement rate (ERR) in rural China. Study design 5-year monthly hospitalisation data, starting 2 years before CII (ie, ‘intervention’) began, were collected. Interrupted time series analysis models used evaluate immediate gradual effects on OOP payment ERR. Setting was conducted Xiantao County, Hubei Province, Participants A total 511 221 inpatients within 5 included analysis. Results In 2016, 100 288 patients received in-patient services, among which 4137 benefited from CII. After implementation CII, expenses increased 32.2% (95% CI 24.8% 39.5%, p<0.001). Compared with preintervention periods, trend changes decline at a 0.7% per month after Similarly, significant decrease observed log ERR intervention started. level change 16% −20.0% −12.1%, Conclusion did not payments 2011–2016 periods. limited extents population financing resources can be attributed these results. Therefore, Chinese government must urgently raise funds policy rate.