Objectives: To study the effects of health financing systems on patient care-seeking behavior in rural China.

Methods: A multistage sampling method was used to select county, township, and village health facilities. A total of 1,232 outpatients was interviewed during two weeks.

Results: Health-financing systems appeared to influence patient behavior. In the insured group, the proportion of patients being hospitalized was higher than that in the uninsured group. Among the different insurance schemes, the private insurance group had the highest proportion of self-medication, but the cooperative insurance group had the lowest; the government insurance group had the most delay days, but the cooperative insurance group had the fewest. A logistic regression analysis suggested that only “out-of-pocket” payment might decrease the access to hospitalization.

Conclusions: The empirical data suggest that health-financing systems appear to influence patient behavior for prescription and access to health care, especially some costly health care, that is, hospitalization. The data also suggest that China needs to increase the coverage of health insurance, especially in rural areas to improve the access to health care.This article resulted from a collaborative research project between IHCAR, Karolinska Institutet and School of Public Health, Fudan University (former Shanghai Medical University)-Health care financing in transitional society-financially supported by the Swedish International Development Cooperation Agency (Sida). Many thanks to Vinod Diwan, Lennart Bogg, and Göran Tomson at IHCAR and Clas Rehnberg at the Stockholm School of Economics for their assistance in the preparation of the article.