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Medical insurance and healthcare utilization among the middle-aged and elderly in China: Evidence from the China health and retirement longitudinal study 2011, 2013 and 2015
journal contributionposted on 18.01.2021, 03:16 by Y Zhou, H Wushouer, Daniel VuillerminDaniel Vuillermin, B Ni, X Guan, L Shi
© 2020 The Author(s). Background: In response to China's rapidly aging population and increasing healthcare service demands, the Chinese government is developing a universal medical insurance system. This study aimed to assess healthcare utilization patterns and analyze the impacts of medical insurance schemes on healthcare utilization among the middle-aged and elderly in China. Methods: Data was extracted from the China Health and Retirement Longitudinal Study in 2011, 2013 and 2015. Healthcare utilization was measured by outpatient and inpatient service utilization. Univariate analysis was deployed to examine the impacts of different medical insurance schemes on healthcare utilization. The factors associated with healthcare utilization were estimated using a random-effects logistic regression model. Results: During the study period, the number of individuals involved was 17,250, 18,195 and 19,842, respectively. The proportion of individuals who received outpatient service was 18.6, 20.7 and 18.7% and those who used inpatient service was 9.6, 13.8 and 14.3%, respectively. We identified that medical insurance was a major protective factor for improving healthcare utilization but different medical insurance schemes exerted various impacts on the middle-aged and the elderly. Conclusions: Despite the growing population coverage, the Chinese government should make every effort to bridge the gap among people with different medical insurance schemes. Further evaluation is needed to assess whether the expanded medical insurance schemes could protect the middle-aged and elderly households from catastrophic health expenditure.
The authors disclosed receipt of the following financial support for the research, authorship, and publication of this article: This work was supported by the National Natural Science Foundation of China [Grant No. 71774005]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
JournalBMC Health Services Research
Article NumberARTN 654
Rights StatementThe Author reserves all moral rights over the deposited text and must be credited if any re-use occurs. Documents deposited in OPAL are the Open Access versions of outputs published elsewhere. Changes resulting from the publishing process may therefore not be reflected in this document. The final published version may be obtained via the publisher’s DOI. Please note that additional copyright and access restrictions may apply to the published version.
Science & TechnologyLife Sciences & BiomedicineHealth Care Sciences & ServicesHealthcare utilizationMedical insuranceAging populationSERVICESHumansAmbulatory CareLogistic ModelsLongitudinal StudiesAgedMiddle AgedInpatientsHealth ExpendituresInsurance, HealthPatient Acceptance of Health CareChinaFemaleMaleHealth Policy & Services