This study reveals the actual medical expenses and guarantee effects of low-income populations based on an empirical analysis of Z County in Southwest China. The findings show that while the triple-layer healthcare security system has reduced the medical burden of low-income patients, the group with serious illness still faces a significant risk of falling back into poverty. Z county’s medical expenditure data indicates that while the nominal reimbursement rate for low-income patients with critical illness is relatively high, the actual reimbursement rate is relatively low, leading to relatively high out-of-pocket expenses for these patients. Additionally, the reimbursement for critical illness tends to be distributed evenly, failing to concentrate limited resources on patients with the most severe and critical illness, which makes it challenging to alleviate the substantial medical costs incurred by critically ill patients. The reimbursement catalogue of basic medical insurance for urban and rural residents should be expanded to alleviate the expenditure pressure outside the scope of patient policy reimbursement. The mechanism of major illness insurance should be improved, the ability of precise guarantee should be enhanced, and the reimbursement structure should be optimized. A diversified guarantee system should be established to reduce the risk of returning to poverty among patients with critical illness. Through the optimization of these measures, the healthcare security level of low-income populations could be effectively elevated, and health equity could be promoted in the context of common prosperity.
Key words
low-income population /
medical expenses /
healthcare security /
critical illness insurance /
risk of returning to poverty /
health equity
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