Exploring the relationship between migrants’ purchasing of commercial medical insurance and urbanisation in China

Liu, Jin Hua; Chen, Hongsheng; Chen, Yang; Li, Peilin

doi:10.1186/s12913-018-3503-1

Cited by 22 publications

(20 citation statements)

References 54 publications

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“…Patients living in rural areas, who usually had a relatively low economic status and were insured by NCMS,25 were ostensibly at a greater risk of CHE. This was the result of the ‘urban–rural dual structure’ of the medical insurance system in China,26 which showed a significant difference in coverage reimbursement scope, payment level and funding level 27. Besides, our study found that a higher severity level of VI caused higher direct costs but received a lower reimbursement rate, which resulted in a dramatically increased risk of CHE with the severity of VI.…”

Section: Discussionmentioning

confidence: 64%

Burden of visual impairment associated with eye diseases: exploratory survey of 298 Chinese patients

Guan

Lin

et al. 2019

BMJ Open

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ObjectivesTo explore the economic burden, prevalence of catastrophic healthcare expenditure (CHE) and the quality of life (QoL) of Chinese patients with visual impairment (VI) associated with eye diseases.DesignA questionnaire survey from March to May 2016 by structured face-to-face interviews of patients with VI.Participants302 patients who were diagnosed with moderate VI or worse in both eyes (visual acuity <6/18) were included, and 298 patients (98.7%) who completed the survey questionnaires were eligible for the study.Outcome measuresThe economic burden was estimated by calculating participants’ direct costs covered in 2015 and the definition of CHE was out-of-pocket (OOP) costs exceeding 30% of annual household income. QoL was weighed by health utility value using time-trade-off valuation techniques.ResultsAnnual average direct costs per patient caused by VI were US$6988.6±US$10 834.3, and 70.3% were direct medical costs of which only 26.9% were reimbursable by medical insurance. 32.2% of households that suffered from CHE, in particular, were less wealthy patients with VI living in rural areas and without medical insurance. The health utility value was rated at 0.65 on average, and patients with VI aged 51–57, living alone and insured by commercial medical insurance had relatively less QoL.ConclusionOur study explored the economic burden and QoL of VI associated with patients with eye diseases in China, indicating a substantial economic burden and poor QoL. Preferential medical insurance policies should be designed in relation to people with VI to further reduce the health inequalities, avoid CHE and promote QoL.

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Section: Discussionmentioning

confidence: 64%

Burden of visual impairment associated with eye diseases: exploratory survey of 298 Chinese patients

Guan

Lin

et al. 2019

BMJ Open

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“…Third, this study found that registered permanent residence status is the most important socioeconomic factor affecting SRH. Under the background of the urban-rural dual structure in China [ 49 ], registered permanent residence reflects the socioeconomic status of residents. Registered permanent residence status has been widely accepted as a factor associated with many diseases [ 50 ], which obviously affects SRH [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

Determinants of self-rated health among an older Tibetan population in a Chinese plateau area: analysis based on the conceptual framework for determinants of health

Nima

et al. 2021

BMC Public Health

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Background Self-rated health (SRH) has been frequently used in population health surveys. However, most of these studies only focus on specific factors that might directly affect SRH, so only partial or confounding information about the determinants of SRH is potentially obtained. Conducted in an older Tibetan population in a Chinese plateau area, the aim of our study is to assess interrelationships between various factors affecting SRH based on the conceptual framework for determinants of health. Methods Between May 2018 and September 2019, 2707 Tibetans aged 50 years or older were recruited as part of the China Multi-Ethnic Cohort Study (CMEC) from the Chengguan District of Lhasa city in Tibet. The information included SRH and variables based on the conceptual framework for determinants of health (i.e., socioeconomic status, health behaviors, physical health, mental health, and chronic diseases). Structural equation modeling (SEM) was used to estimate the direct and indirect effects of multiple factors in the conceptual framework. Results Among all participants, 5.54% rated their health excellent, 51.16% very good, 33.58% good, 9.12% fairly poor and 0.59% poor. Physical health (β = − 0.23, P < 0.001), health behaviors (β = − 0.44, P < 0.001), socioeconomic status (β = − 0.29, P < 0.001), chronic diseases (β = − 0.32, P < 0.001) and gender (β = 0.19, P < 0.001) were directly associated with SRH. Socioeconomic status, physical health and gender affected SRH both directly and indirectly. In addition, there are potential complete mediator effects in which age and mental health affect SRH through mediators, such as physical health, health behaviors and chronic diseases. Conclusions The findings suggested that interventions targeting behavioral changes, health and chronic disease management should be attached to improve SRH among older populations in plateau areas without ignoring gender and socioeconomic disparities.

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“…The physically demanding job and poor work environment may induce migrants’ chronic diseases and physical injuries, which subsequently increase the risk of mental illness. Furthermore, due to the limited access to health care and the poor flexibility of medical insurance transferability, migrants may have to bear more burden of medical expenses without reimbursement, which can also contribute to their life pressure and emotional problems [ 20 , 21 , 22 ]. In addition, with the lack of social pension insurance, migrants might also develop negative emotions, such as anxiety and depression, when considering their living quality after they become old [ 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Internal Migration Experience and Depressive Symptoms among Middle-Aged and Older Adults: Evidence from China

Zheng

Yue

Chen

et al. 2021

IJERPH

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Background: This study aimed to examine the association of internal migration experience with depressive symptoms among middle-aged and elderly Chinese, as well as explore possible mechanisms of the relationship. Methods: Participants were from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative sample of residents aged 45 years and older (n = 43,854). Survey data on depressive symptoms and internal migration experience were collected from biennial CHARLS surveys (CHARLS 2011/2013/2015) and a unique CHARLS life history survey in 2014, respectively. Multiple logistic regressions and the Karlson–Holm–Breen (KHB) method were employed in the statistical analyses. Results: The overall prevalence rate of depressive symptoms among middle-aged and older adults was 34.6%. Internal migration experience was associated with higher risks of depressive symptoms (OR = 1.07, 95% CI = 1.02–1.12, p < 0.01), especially among females (OR = 1.08, 95% CI = 1.01–1.14, p < 0.05), middle-aged adults (OR = 1.12, 95% CI = 1.06–1.19, p < 0.001), rural-to-urban migrants who had not obtained an urban hukou (OR = 1.13, 95% CI = 1.07–1.19, p < 0.001), and those who had low migration frequency and first migrated out at 35 years of age or older. Chronic disease (17.98%, p < 0.001), physical injury (7.04%, p < 0.001), medical expenditure (7.98%, p < 0.001), pension insurance (4.91%, p < 0.001), and parent–child interaction (4.45%, p < 0.01) were shown to mediate the association of internal migration experience with depressive symptoms. Conclusions: This study indicates that there is a significant association between internal migration experience and high risks of depression onset later in life. It is suggested to reduce institutional barriers for migrants and implement evidence-based interventions to improve migrants’ mental health.

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Exploring the relationship between migrants’ purchasing of commercial medical insurance and urbanisation in China

Cited by 22 publications

References 54 publications

Burden of visual impairment associated with eye diseases: exploratory survey of 298 Chinese patients

Burden of visual impairment associated with eye diseases: exploratory survey of 298 Chinese patients

Determinants of self-rated health among an older Tibetan population in a Chinese plateau area: analysis based on the conceptual framework for determinants of health

Internal Migration Experience and Depressive Symptoms among Middle-Aged and Older Adults: Evidence from China

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