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Table 1 Comparison of UEBMI and URBMI policies for ESKD patients in Guangzhou city in 2013

From: Direct medical costs of end-stage kidney disease and renal replacement therapy: a cohort study in Guangzhou City, southern China

 UEBMIURBMI
Inception year20022008
Eligible populationUrban employedUrban non-employed
(Employees; Retirees)(Children & full-time Students; Unemployed adults;
 Elderly residents not covered by the UEBMI scheme)
Sources of fundingThe employers contribute 6% of the employee’s salaryGovernment subsidy (70%) and individual premium (30%)
whilst the employees contribute 2%;CNY440 to CNY1800 per person per year for residents
Retirees are exempted from premium contribution(including government subsidy)
AccountsMedical Savings Account (including employeeSocial Risk-pooling Account (all funds) for inpatient
contributions and 30% of employer contributions)care and critical (i.e. chronic or fatal diseases including
for outpatient care; Social Risk-pooling Account (70%ESKD) outpatient care
of employer contributions) for inpatient care and    
critical (i.e. chronic or fatal diseases including    
ESKD) outpatient care    
 CRITICAL OUTPATIENTCRITICAL OUTPATIENT
Benefit packages of Social Risk-pooling Account(HD, PD, KT immunosuppression)(HD, PD, KT immunosuppression)
EmployeesPrimary hospitals90%Children & studentsPrimary hospitals85%
Secondary hospitals85%Secondary hospitals75%
Reimbursement ratea (Outpatient care)Tertiary hospitals80%Tertiary hospitals65%
RetireesPrimary hospitals93%Unemployed adults andPrimary hospitals85%
Secondary hospitals89.5%Elderly residentsSecondary hospitals70%
Tertiary hospitals86%Tertiary hospitals55%
Reimbursed ceiling (Outpatient care)HD and PD: No monthly ceilingHD and PD: No monthly ceiling
KT immunosuppression: CNY6000 monthlyKT immunosuppression: CNY5500–6000 monthly
 INPATIENTINPATIENT
Deductible: (Inpatient care)EmployeesPrimary hospitalsCNY400Children & studentsPrimary hospitalsCNY120
Secondary hospitalsCNY800Secondary hospitalsCNY240
Tertiary hospitalsCNY1600Tertiary hospitalsCNY480
RetireesPrimary hospitalsCNY280Unemployed adults andPrimary hospitalsCNY280
Secondary hospitalsCNY560Elderly residentsSecondary hospitalsCNY560
Tertiary hospitalsCNY1120Tertiary hospitalsCNY1120
Reimbursement ratea (Inpatient care)EmployeesPrimary hospitals90%Children & studentsPrimary hospitals85%
Secondary hospitals85%Secondary hospitals75%
Tertiary hospitals80%Tertiary hospitals65%
RetireesPrimary hospitals93%Unemployed adults andPrimary hospitals75%
Secondary hospitals89.5%Elderly residentsSecondary hospitals65%
Tertiary hospitals86%Tertiary hospitals55%
Reimbursed ceiling (Inpatient care)Six times of local employees’ annual average wageSix times of local household disposable income
CNY382,512  CNY228,324  
  1. Notes: Policy information was obtained from Statistical Bulletin of Guangzhou Social Insurance Bureau, and policy documents
  2. ESKD patients were exempt from deductibles for HD, PD, KT immunosuppression in the outpatient sector in Guangzhou
  3. aThe percentages were the reimbursement rates of the eligible medical expenses that could be reimbursed from the Social Risk-pooling Account in Guangzhou
  4. Abbreviations: UEBMI Urban Employee-based Basic Medical Insurance scheme, URBMI Urban Resident-based Basic Medical Insurance scheme, ESKD end-stage kidney disease, HD Haemodialysis, PD Peritoneal Dialysis, KT Kidney Transplantation, CNY Chinese Yuan
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