Uncompensated care for children without insurance or from low-income families in a Chinese children’s hospital

BACKGROUND In China, children from low-income families, particularly those of rural to urban migrant families, have become one of the most vulnerable populations in terms of healthcare access. Without support, these families will finally give up treatment for their children. Our hospital has sought several ways to fund the uncompensated care for children without insurance or from low-income families. MATERIAL AND METHODS The annual hospital financial report and donated patients' medical records from 2005 to 2011 were reviewed for extracting data, including disease type, and sources and amounts of donations. Files with information on uncompensated care were also reviewed. Uncompensated care was defined as the sum of a hospital's "bad debt" and the charity care it provides. RESULTS The total expense of uncompensated care increased from 813 597 RMB in 2005 to 4 415 967 RMB in 2011, with a percentage of total budget ranging from 0.24% to 1.6% from 2005 to 2011. The hospital's bad debt accounts for 17.6% of the uncompensated care charge on average per year. The charity care was from: 1) donations from common warm-hearted persons, companies, and institutions after media reporting; 2) governmental charity organizations; 3) non-governmental charity organizations; and 4) special funding from contributions solicited by hospital, media, and governmental charity organizations' collaboration. Leukemia and congenital heart disease were the 2 leading types of diseases benefitted from the uncompensated care from 2005 to 2011. CONCLUSIONS Uncompensated care is still an indispensable complementary supporting measure for pediatric care access in China. Children from rural-to-urban migrant families should be considered as a target population for the government to focus on.