Financial protection effects of private health insurance: experimental evidence from Chinese households with resident basic medical insurance

Fu, Xiaoxiao

doi:10.1186/s12939-021-01468-5

Cited by 11 publications

(7 citation statements)

References 37 publications

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“…Furthermore, this article identified several key determinants of CHE incidence and most of them were similar with prior studies [14,43,44]. As we expected, higher annual per capita household income and better self-rated health status of the household head were both significantly associated with lower CHE incidence.…”

Section: Discussionsupporting

confidence: 83%

The comparison of catastrophic health expenditure and its inequality between urban and rural households in China

2022

Health Econ Rev

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Background In recent years, the goal of universal coverage of the basic medical insurance schemes has been basically achieved in China, but the heavy economic burden of diseases is still the main cause of poverty in many households. Exploring catastrophic health expenditure (CHE) and its inequality are highly important for forward-looking policymaking. This study aims to compare the incidence, intensity and inequality of CHE between urban and rural households in China. Methods This study was based on a national representative household survey—the China Family Panel Studies (CFPS)—that was conducted from 2012 to 2018. Concentration index (CI) was employed to measure the inequality of CHE incidence and overshoot, while the decomposition method of the CI was used to estimate the main influencing factors affecting inequality of CHE incidence. Results From 2012 to 2018, the CHE incidence of urban households increased from 11.01 to 11.88%, while the CHE incidence of rural households decreased from 18.42 to 18.31%. During the same period, the CI of CHE incidence for urban households decreased from − 0.1480 to − 0.1693, while that for rural households declined from − 0.1062 to − 0.1501. The major contribution to the pro-poor inequality in CHE incidence was associated with socioeconomic status, lagged CHE, receiving inpatient services, having elderly members, education of household head, and self-assessed health status of household head. Conclusions Rural households had higher risk of incurring CHE than urban households. The strong pro-poor inequality for CHE incidence and overshoot could be found in both two groups. The problem of poverty due to illness was more severe among low-income groups in rural areas than in urban areas. The relevant policy interventions should further focus on encouraging the development of supplementary medical insurance and increasing the reimbursement rate for hospitalization expenses in the medical assistance system.

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Section: Discussionsupporting

confidence: 83%

The comparison of catastrophic health expenditure and its inequality between urban and rural households in China

2022

Health Econ Rev

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“…However, many studies showed that the insured tends to utilize services that are exclusively covered by PHI, such as physical examinations, cancer screening, innovative drugs, and so on ( 38 , 39 ), to better manage their current health conditions. The results revealed that although the use of relatively expensive services such as hospitalization did not increase ( 40 ), the insured received more valuable health services and reduced financial risks ( 41 , 42 ). Contrastingly, the second path is more cost effective, consistent with the current popular and advanced concept of value-based insurance design (VBID) ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

Can supplementary private health insurance further supplement health

Chen

Guo²,

Tan³

et al. 2022

Front. Public Health

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BackgroundChina advocates a health insurance system with social health insurance (SHI) as the main body and private health insurance (PHI) as the supplement. The study of PHI's complementary role in health is conducive to providing evidence for PHI's policy expansion and encouraging the public to participate in PHI, which is insufficient in China.MethodsWe used the three-wave balanced panel data of the China Health and Retirement Longitudinal Survey (CHARLS). Taking the ownership of supplementary PHI as the independent variable and EQ-5D index scores as the dependent variable, the panel instrumental variable (IV) method was used to analyze the impact of participation in PHI on health. We also assessed the heterogeneity of the health effects of PHI between chronic and non-chronic disease groups and between low- and high-income groups.ResultsThe coverage rate of PHI at baseline was 10.53%. The regression results showed that participating in PHI on the basis of SHI could result in an additional 8.21% health gain (p < 0.001). At the same time, PHI had greater health gain for chronic disease population than for healthy population (9.25 vs. 6.24%, p < 0.001), and greater health gain for high-income population than for low-income population (8.32 vs. 5.31%, p < 0.001).ConclusionParticipating in supplementary PHI can effectively enhance the health status of the insured, and has a more significant effect on patients with chronic diseases. The development of PHI should be further supported, while the health inequality in different income groups should be paid attention to.

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“…In this study, we found that of all individuals, the proportion of enrolled individuals shows an increasing trend year by year, with 8.7%,11.8% and 14.1% enrolled in CMI in 2015,2018 and 2021, respectively. This is also a significant increase compared to the 6.9% coverage rate estimated from the China’s National Health Service Survey in 2013 [ 33 ]. However, compared with the United States and some developed European countries, the coverage of CMI in China is relatively low.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the enrollment of commercial medical insurance in China: Results from China General Social Survey

Xue,

Zeng,

Yang

et al. 2024

PLoS ONE

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Background The Chinese government has been promoting commercial medical insurance (CMI) in recent decades as it plays an increasingly important role in addressing disease burden, health inequities, and other healthcare challenges. However, compared with developed countries, the CMI is still less fledged with low coverage. Objective This study aims to explore the factors associated with enrollment in CMI, with regards to explicit characteristics (including sociodemographic characteristics and family economic status), latent characteristics (including social security status), and the global incentive compatibility index (including health status), to inform the design of CMI to improve its coverage in China. Methods Based on the principal-agent model, we summarized and classified the factors associated with the enrollment in CMI, and then analyzed the data generated from the Chinese General Social Survey in 2015,2018 and 2021 respectively. A comparison of factors regarding sociodemographic characteristics, family economic status, social security status, and health status was conducted between individuals enrolled and unenrolled in CMI using Mann-Whitney U test and Chi-square test. Binary logistic regression analysis was used to explore factors influencing the enrollment status of CMI. Results Of all individuals, the proportion of enrolled individuals shows an increasing trend year by year, with 8.7%,11.8% and 14.1% enrolled in CMI in 2015,2018 and 2021, respectively. The binary regression analysis further suggested that the factors associated with the enrollment in CMI were consistent in 2015,2018 and 2021.We found that individuals divorced, obese, who had a higher level of education, had non-agricultural household registration, perceived themselves as the upper social status, conducted daily exercise, had more family houses, had a car, had investment activities, or did not have basic health insurance were more likely to be enrolled in CMI. Conclusions We identified multidimensional factors associated with the enrollment of CMI, which help inform the government and insurance industry to improve the coverage of CMI.

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Financial protection effects of private health insurance: experimental evidence from Chinese households with resident basic medical insurance

Cited by 11 publications

References 37 publications

The comparison of catastrophic health expenditure and its inequality between urban and rural households in China

The comparison of catastrophic health expenditure and its inequality between urban and rural households in China

Can supplementary private health insurance further supplement health

Factors associated with the enrollment of commercial medical insurance in China: Results from China General Social Survey

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