Impact of new rural cooperative medical scheme on the equity of health services in rural China

Background To explore the equity in health services in the rural areas, by studying the rural residents in two counties of Ningbo City, Zhejiang. Methods Multi-stage stratified cluster random sampling method was performed to draw the study sample. Trained investigators conducted face to face interviews using a questionnaire. Rural residents were stratified into 5 income groups. Centralized index (CI) and risk ratios (RR) were used to assess the equity in health services and the impact of the New Cooperative Medical Scheme (NCMS). Results The centralized index of the 2 weeks prevalence, two-week visiting rate and chronic disease prevalence among different income groups was − 0.0264, − 0.0076 and − 0.0160, respectively, while that of the hospitalization rate was 0.0006. The highest NCMS coverage rate, adjusted risk of disease and catastrophic health expenditure (CHE) rates were observed in lowest income groups (92.86, 4.94 and 32.21%, respectively. Two-week prevalence, chronic diseases prevalence and RR showed a declining trend with increasing income levels. Conclusion NCMS has improved the service availability and reduced the economic burden of diseases. However, its impact on reducing the economic risk of illness and promoting equity in health services has not been significant.