Abstract
BackgroundChina has nearly achieved universal health insurance coverage, but considerable unmet healthcare needs still exist. Although this topic has attracted great attention, there have been few studies examining the relationship between universal health insurance coverage and unmet healthcare needs. This study aimed to clarify the impact of universal health insurance coverage and other associated factors on Chinese residents’ unmet healthcare needs.MethodsData was derived from the fourth, fifth, and sixth National Health Service Survey of Jiangsu Province, which were conducted in 2008, 2013, and 2018, respectively. Descriptive statistics were used to analyze the prevalence of unmet healthcare needs. Binary multivariate logistic regression was used to estimate the association between unmet healthcare needs and universal health insurance coverage, along with other socioeconomic factors.Results8.99%, 1.37%, 53.37%, and 13.16% of the respondents in Jiangsu Province reported non-use of outpatient services, inpatient services, physical examinations, and early discharge from hospital, respectively. The trend in the prevalence of unmet healthcare needs showed a decline from 2008 to 2018. Health insurance had a significant reducing effect on non-use of outpatient services, inpatient services, or early discharge from hospital. People having health insurance in 2013 and 2018 were significantly less likely to report unmet healthcare needs compared to those in 2008. The effect of health insurance and its universal coverage on reducing unmet healthcare needs was greater in rural than in urban areas. Other socioeconomic factors, such as age, marital status, educational level, income level, or health status, also significantly affected unmet healthcare needs.ConclusionsUniversal health insurance coverage has significantly reduced Chinese residents’ unmet healthcare needs. Policy efforts should pay more attention to the benefits of health insurances in rural areas and optimize urban-rural health resources to promote effective utilization of healthcare.
Highlights
The World Health Organization defines universal health coverage (UHC) as the ability for all people to access equal health services that are effective and do not expose the user to financial hardship [1], and this is a major sustainable development goal all over the world
The improvement of its coverage can effectively reduce the inequality of health service utilization caused by financial hardship, improve the utilization and accessibility of health services and reduce the degree of healthcare underutilization, so as to promote the realization of UHC [6, 7].With the implementation of the New Medical Reform Plan in 2009, China has established a social health insurance system framework consisting of Urban Employees Medical Insurance, Urban Residents’ Medical Insurance, and the New Rural Cooperative Medical Scheme, and these cover the employed urban population, unemployed urban residents, and rural residents, respectively
To estimate the effect of the whole process of universal health insurance coverage on unmet healthcare needs, we introduced year dummies and cross-variables of insurance interacting with these year dummies
Summary
The World Health Organization defines universal health coverage (UHC) as the ability for all people to access equal health services that are effective and do not expose the user to financial hardship [1], and this is a major sustainable development goal all over the world. These health services include health promotion, prevention, treatment, rehabilitation, and palliative care [2]. China has nearly achieved universal health insurance coverage, but considerable unmet healthcare needs still exist. This study aimed to clarify the impact of universal health insurance coverage and other associated factors on Chinese residents’ unmet healthcare needs
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