Poor people in China paid a smaller share of inpatient costs directly in 2018 than five years earlier, a survey-based study found, as a Lancet Commission reviewed the country’s health-focused poverty program.
In the study’s poor population, out-of-pocket payments made up 41.9% of inpatient expenses in 2013 and 31.9% in 2018. For poor rural residents, the proportion declined from 41.0% to 31.0% over the same survey years. Both comparisons show a 10 percentage-point drop.
The study defined poverty using provincial poverty and low-income thresholds, which covered a broader group than China’s national poverty line. Its findings therefore apply to the population captured by those wider criteria.
The Lancet Commission report was published online Oct. 29, 2026, and launched at Tsinghua University that day. Tsinghua said the Health and Poverty Alleviation Initiative paired financial protection and primary health care with measures involving safe drinking water, housing, nutrition and education. The university said about 1.4 trillion yuan was invested in health-related poverty alleviation from 2015 to 2020.
A Lancet editorial accompanying the report said China launched the initiative in 2015 as part of its national poverty-reduction strategy. The survey figures compare 2013 and 2018; they do not establish which policies drove the decline in out-of-pocket shares.
Tsinghua said the policies overlapped, and the available evidence could not quantify the contribution of each measure.
