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Table 1 Comparison of UEBMI and URBMI policies in Guangzhou city in 2014

From: Direct medical costs for patients with schizophrenia: a 4-year cohort study from health insurance claims data in Guangzhou city, Southern China

Inception year 2002 2008
Eligible population Urban employed (employees; retirees) Urban non-employed (children and full-time students; unemployed adults; elderly residents not covered by the UEBMI scheme)
Sources of funding The employers contribute 6% of the employee’s salary whilst the employees contribute 2%
Retirees are exempt from premium contribution
Government subsidy (70%) and individual premium (30%)
CNY440 to CNY1800 per person per year for residents (including government subsidy)
Accounts Medical savings account (including employee contributions and 30% of employer contributions) for outpatient care; social risk-pooling account (70% of employer contributions) for inpatient care and critical (i.e. chronic or fatal diseases including schizophrenia) outpatient care Social risking-pooling account (all funds) for inpatient care and critical (i.e. chronic or fatal diseases including schizophrenia) outpatient care
Service package Comprehensive Limited
  Inpatient Inpatient
Benefit packages of social risk-pooling account Employees Primary hospitals 90% Children and students Primary hospitals 85%
Secondary hospitals 85% Secondary hospitals 75%
Tertiary hospitals 80% Tertiary hospitals 65%
Reimbursement rate (Inpatient care) Retirees Primary hospitals 93% Unemployed adults and elderly residents Primary hospitals 85%
Secondary hospitals 89.5% Secondary hospitals 70%
Tertiary hospitals 86% Tertiary hospitals 55%
Reimbursed ceiling (Inpatient care) Six times of local employees’ annual average wage per year (CNY445,470) Six times of local household disposable income per year (CNY228,324)
  Critical outpatient Critical outpatient
Reimbursement rate (Outpatient care) Community health centers 85% Community health centers 70%
  Non-community institutes 65% Non-community institutes 50%
Reimbursed ceiling (Outpatient care) CNY150 per person per month CNY100 per person per month
  1. Policy information was obtained from Statistical Bulletin of Guangzhou Social Insurance Bureau, and policy documents; Schizophrenia patients are exempt from deductible for hospitalization in Guangzhou
  2. UEBMI Urban Employee Basic Medical Insurance scheme, URBMI Urban Resident Basic Medical Insurance scheme, CNY Chinese Yuan