Impact of China's Urban Resident Basic Medical Insurance on Health Care Utilization and Expenditure

Liu, Hong; Zhao, Zhong

doi:10.2139/ssrn.2157910

Cited by 19 publications

(7 citation statements)

References 23 publications

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“…One potential explanation is that households in western China are prone to forgo needed health services due to their low income [38]. None of the three types of basic medical insurance schemes, including UEBMI, URBMI and NRCMS, significantly reduced the incidence and intensity of CHE in both two groups, which is consistent with some existing literature [11,22,[39][40][41]. The weak effect of basic medical insurance in reducing the incidence and intensity of CHE could be attributed to the relatively lower level of scope and actual reimbursement rate, as well as the heavy economic burden of NCDs [23].…”

Section: Discussionsupporting

confidence: 86%

Urban-rural differences in catastrophic health expenditure among households with chronic non-communicable disease patients: evidence from China Family Panel Studies

Sun

et al. 2020

Preprint

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BackgroundThe prevalence of chronic non-communicable diseases (NCDs) challenges the Chinese health system reform. Little is known for the differences in catastrophic health expenditure (CHE) between urban and rural households with NCD patients. This study aims to measure the differences above and quantify the contribution of each variable in explaining the urban-rural differences.MethodsThe second and the fourth waves of the China Family Panel Studies (CFPS) data, conducted in 2012 and 2016, were employed in this cross-sectional study. The techniques of Fairlie nonlinear decomposition and Blinder-Oaxaca decomposition were employed to measure the contribution of each independent variable to the urban-rural differences.ResultsThe CHE incidence and intensity of households with NCD patients were significantly higher in rural areas than in urban areas. The explained disparity of CHE incidence increased from 3.15% in 2012 to 27.04% in 2016, and the corresponding values of CHE intensity rose from 21.30% in 2012 to 53.37% in 2016. The major contribution to the urban-rural differences in CHE was associated with household economic status, education level, health status and supplementary medical insurance (SMI).ConclusionsCompared with urban households with NCD patients, rural households with NCD patients have higher risk of incurring CHE and heavier economic burden of diseases. Policy interventions should give priority to decreasing the urban-rural disparity in observable characteristics mentioned above.

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Section: Discussionsupporting

confidence: 86%

Urban-rural differences in catastrophic health expenditure among households with chronic non-communicable disease patients: evidence from China Family Panel Studies

Sun

et al. 2020

Preprint

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“…were not significand related to utilization of medical insurance, but other findings showed that people who had high education were likely to use outpatient services. It is similar with findings in Liu & Zhao and Zhou et al (Liu & Zhao, 2012;Zhou et al, 2020).…”

Section: B) Enabling Factorssupporting

confidence: 92%

Association between medical insurance choices and healthcare utilization among diabetes patients in The People's Republic of China : a secondary data analysis

Chen

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Since�2018, the universal medical insurance coverage rate has reached 95% in China. Due to the lack of medical and health resources and insufficient health service capacity of primary health care facilities in China, the biggest problem with the health system in China is overcrowding, especially in the utilization of outpatient services in secondary and tertiary hospitals. ��This study aimed to analyze the factors Association between Medical insurance Choices and healthcare Utilization among diabetes patients among patients of age >45 years in China. The logistic regression was used to assess the association between type of hospital of elder diabetic patients and basic medical insurance in China. Data from 2018 waves of the China Health and Retirement Longitudinal Survey were used, 19,305 samples were analyzed. ��This study found that among Chinese middle-aged and elderly, diabetes patients with other chronic disease increased the likelihood of using outpatient care in hospital than compared to patients without diabetes and diabetes patients without other chronic diseases. The results also found that among Chinese middle-aged and old adults, underweight people increased the likelihood of using outpatient care than healthy weight people.� ��Based on the findings of this study, reducing the utilization of outpatient services in secondary and tertiary hospitals in China were required improving the quality of services rendered from primary health care facilities and the utilization of primary health care facilities. As a result, this study would like to suggest that continue to promote the hierarchical diagnosis and treatment system and establish medical treatment partnerships, to improve medical insurances system.

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“…[19,20] Those variables showing VIF less than two were only taken for regression analysis. [21] All the variables except ethnicity showed VIF less than two and were tted in the nal multivariable logistic regression model. We set the level of signi cance at 5%.…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Health Insurance Utilization among Insured Population: Evidence from Health Insurance Program of Bhaktapur District of Nepal

Ghimire

Khanal

et al. 2022

Preprint

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Background The Government of Nepal introduced the family-based health insurance program in 2016 to increase financial protection and improve access to health care services. The aim of the study was to assess factors associated with the utilization of health insurance among insured population in an urban district of Nepal. Methods A cross-sectional survey using face-to-face interviews was conducted in 224 households of Bhaktapur district of Nepal. Household heads were interviewed using a structured questionnaire. Logistic regression with weighted analysis was done to identify predictors of service utilization among the insured residents. Results The prevalence of health insurance service utilization at the household level in the Bhaktapur district was 77.2% (n = 224). The number of elder members in the family (AOR 2.7, 95% CI 1.09–7.07), having family member with chronic illness (AOR 5.10, 95% CI 1.48–17.56), willingness to continue health insurance (AOR 2.18, 95% CI 1.47–3.25) and membership duration (AOR 1.14, 95% CI 1.05–1.24) were significantly associated with the utilization of the health insurance at the household level. Conclusion The study identified a particular group of the population who were more likely to utilize health insurance services, including the chronically ill and elderly. Health insurance program in Nepal would benefit from strategies to increase population coverage in health insurance, improve quality of health services, and retain members in the program.

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Impact of China's Urban Resident Basic Medical Insurance on Health Care Utilization and Expenditure

Cited by 19 publications

References 23 publications

Urban-rural differences in catastrophic health expenditure among households with chronic non-communicable disease patients: evidence from China Family Panel Studies

Urban-rural differences in catastrophic health expenditure among households with chronic non-communicable disease patients: evidence from China Family Panel Studies

Association between medical insurance choices and healthcare utilization among diabetes patients in The People's Republic of China : a secondary data analysis

Factors Affecting Health Insurance Utilization among Insured Population: Evidence from Health Insurance Program of Bhaktapur District of Nepal

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