Urban and Rural Disparities in Healthcare Utilization and Expenditures Among Rural Hukou Beneficiaries of New Cooperative Medical Scheme in China

Luo, Dian; Ma, Yingjie; Deng, Jing

doi:10.21203/rs.2.15908/v1

Cited by 1 publication

(3 citation statements)

References 27 publications

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“…Additionally, the study concludes that, in comparison to UEBMI and URBMI, the synergy between NRCMS and PHI is more harmonious, with government policies more supportive of this combination. This assertion corresponds with findings in existing literature, such as those by Chai Huamin [15] and Luo Jingxian [32], both empirically demonstrating a more pronounced impact of PHI on NRCMS patients, signifying a substantially higher policy effect of PHI in rural areas compared to urban areas.…”

Section: Discussionsupporting

confidence: 91%

“…This enhancement contributes, to a certain extent, to improved access to high-quality healthcare for the PHI insured, thereby mitigating the disparities in healthcare utilization between urban and rural areas. This finding aligns with the research conducted by international scholars Rodríguez M,Jones A. M,et al [18][19][20][21] and chinese scholars Luo Jingxian [32]. However, for UEBMI and URBMI participants with PHI, the results indicate a higher inclination toward selecting higher-level hospitals compared to those without PHI, although this difference lacks statistical significance.…”

Section: Discussionsupporting

confidence: 87%

“…This observation aligns with Yang Liu's research, which underscores that the burden reduction effect of NRCMS primarily manifests in outpatient medical services, while PHI predominantly influences inpatient medical care [30]. Similarly, Luo Jingxian [32] notes that, given the low reimbursement ratio of hospitalization expenses under NRCMS, PHI exerts a more pronounced negative impact on hospitalization costs, leading residents to exhibit a relatively higher propensity to choose hospitalization for their illnesses. This inclination can be attributed to the prevalent types of PHI available in the market, which largely concentrate on hospitalization insurance formats, such as fixed benefit insurance for major diseases, compensatory insurance for hospitalization medical expenses, and hospitalization allowances [33].…”

Section: Discussionsupporting

confidence: 76%

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Does supplemental private health insurance impact health care utilization and seeking behavior of residents covered by social health insurance? Evidence from China National Health Services Survey

Bie,

Yan,

Qiu

et al. 2024

Int J Equity Health

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Background Supplemental private health insurance (PHI) plays a crucial role in complementing China’s social health insurance (SHI). However, the effectiveness of incorporating PHI as supplementary coverage lacks conclusive evidence regarding its impact on healthcare utilization and seeking behavior among SHI-covered individuals. Therefore, investigating the effects of supplementary PHI on health care utilization and seeking behavior of residents covered by social health insurance is essential to provide empirical evidence for informed decision-making within the Chinese healthcare system. Methods Data from the 2018 China National Health Services Survey were analyzed to compare outpatient and inpatient healthcare utilization and choices between PHI purchasers and non-purchasers across three SHI schemes: urban employee-based basic medical insurance (UEBMI), urban resident-based basic medical insurance (URBMI), and the new rural cooperative medical scheme (NRCMS). Using the Andersen Healthcare Services Utilization Behavior Model as the theoretical framework,binary logistic regression and multinomial logistic regression (MNL) models were employed to assess the impact of PHI on healthcare utilization and provider preferences. Results Among UEBMI, URBMI, and NRCMS participants with PHI, outpatient visit rates were 17.9, 19.8, and 21.7%, and inpatient admission rates were 12.4, 9.9, and 12.9%, respectively. Participants without PHI exhibited higher rates for outpatient visits (23.6, 24.3, and 25.6%) and inpatient admissions (15.2, 12.8, and 14.5%). Binomial logistic regression analyses revealed a higher probability of outpatient visits and inpatient admissions among UEBMI participants with PHI (p < 0.05). NRCMS participants with PHI showed a lower probability of outpatient visits but a higher probability of inpatient admissions (p < 0.05). Multinomial logistic regression indicated that NRCMS participants with PHI were more likely to choose higher-level hospitals, with a 17% increase for county hospitals and 27% for provincial or higher-level hospitals compared to primary care facilities. Conclusion The findings indicate that the possession of PHI correlated with increased utilization of outpatient and inpatient healthcare services among participants covered by UEBMI. Moreover, for participants under the NRCMS, the presence of PHI is linked to a proclivity for seeking outpatient care at higher-level hospitals and heightened utilization of inpatient services. These results underscore the nuanced influence of supplementary PHI on healthcare-seeking behavior, emphasizing variations across individuals covered by distinct SHI schemes.

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Section: Discussionsupporting

confidence: 91%