The Effects of Social Health Insurance Reform on People's Out-of-Pocket Health Expenditure in China
Kai Liu
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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

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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 i...