Journal Article

Institutional differences and geographical disparity: the impact of medical insurance on the equity of health services utilization by the floating elderly population - evidence from China

Han, Junqiang, Meng, Yingying

2019

Overview

Background The Chinese government has now achieved universal coverage of medical insurance through two systems: the Basic Medical Insurance System for Urban Employees (BMISUE) and the Basic Medical Insurance System for Urban and Rural Residents (BMISURR). This paper aims to identify the impact of China’s current medical insurance system on equity in the use of health services by the floating elderly population from two aspects: institutional differences and geographical disparity. Methods The data used in the study are from the China Migrants Dynamic Survey (CMDS) conducted by the National Health and Wellness Council of China. This study uses the Logit model to estimate the impact of the medical insurance system on the utilization of health services and the Propensity Score Matching (PSM) method to further test the robustness of the results. Results The study found that the type of medical insurance does not affect health services utilization by the floating elderly population in China. However, for those participating in the same medical insurance, participation in different regions will significantly affect the use of health service resources. For the BMISURR, when the place of the insurance is the same as the place of residence, the proportion of the floating elderly population that will see a doctor when they are sick will increase by 4.80%. For the BMISUE, when the place of the insurance is the same as the place of residence, the proportion of the floating elderly population that will see a doctor when they are sick will increase by 10.30%. Conclusions The difference between the place of insurance and the place of residence results in the unbalanced utilization of health services by the floating elderly population participating in the same medical insurance system.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adolescent / Adult / Aged / Aged, 80 and over / Analysis / China / Elderly / Employees / Equality and Human Rights / Experiments / Fairness / Female / Geography / Geriatrics / Health aspects / Health care disparities / Health care industry / Health care policy / Health care reform / Health disparities / Health insurance / Health Policy / Health Promotion and Disease Prevention / Health service / Health services / Health Services Research / Health services utilization / Healthcare Disparities - statistics & numerical data / Hospitals / Humans / Inequity / Insurance / Insurance coverage / Insurance, Health - statistics & numerical data / Logit models / Male / Medical care / Medical care utilization / Medical insurance / Medical research / Medically uninsured persons / Medicine / Medicine & Public Health / Middle Aged / Migrants / Older people / Participation / Patient Acceptance of Health Care - statistics & numerical data / Physicians / Population / Population growth / Propensity / Public Health / Residence / Robustness / Rural Health Services - statistics & numerical data / Rural Population - statistics & numerical data / Rural populations / Rural urban differences / Services / Social aspects / Social Justice / Social Policy / Surveys and Questionnaires / Test procedures / The basic medical insurance system for urban employees / The floating population / Uninsured people / Universal Health Insurance - statistics & numerical data / Urban Health Services - statistics & numerical data / Urban population / Urban Population - statistics & numerical data / Utilization / Workers / Young Adult