Health insurance coverage and access to care in China

De-Chih Lee,Leiyu Shi,Jing Wang,Caroline Wu,Gang Sun

doi:10.1186/s12913-022-07498-1

Abstract

ObjectiveThe study examined the relationship between health insurance coverage and access to needed healthcare including preventive, primary, and tertiary care among Chinese adult population.Data and methodsData for this study came from the 2018 China Health and Retirement Longitudinal Study (CHARLS), a population-based probability sample survey. Key measures included insurance coverage (high-, moderate-, low- and no-insurance), access to care (physical examination, physician visit, office visit, inpatient care, and satisfaction with care), and personal sociodemographics. Multiple-factor generalized linear mixed model was applied to estimate the odds ratio (OR) and the 95% confidence interval (CI) of HI coverage for the four indicators of access to care, after controlling for individual characteristics and aggregation among different villages.ResultsThe majority of Chinese adults had some health insurance with only 3.15% uninsured. However, most had low-coverage insurance (64.82%), followed by moderate-coverage insurance (16.70%), and high-coverage insurance (15.33%). Health insurance was significantly and positively associated with access to needed healthcare (preventive, primary, and tertiary). There was also a significant gradient association between extent of insurance coverage and access to care.ConclusionNot only health insurance mattered in enhancing access to care but that there was a significant gradient association between extent of insurance coverage and access to care with higher coverage relating to better access.

Highlights

Health insurance (HI) is part of social security that assures the provision of necessary health services to citizens in return for periodic pecuniary tax contributions [1]
Conclusion: health insurance mattered in enhancing access to care but that there was a significant gradi‐ ent association between extent of insurance coverage and access to care with higher coverage relating to better access
Data Data for this study came from the China Health and Retirement Longitudinal Study (CHARLS) project, a large-scale interdisciplinary survey project sponsored by the National Development Research Institute of Peking University and jointly implemented by China Social Science Survey Center of Peking University and Youth League Committee of Peking University in 2018

Summary

Introduction

Health insurance (HI) is part of social security that assures the provision of necessary health services to citizens in return for periodic pecuniary tax contributions [1]. Managed care and strategic purchasing options have been promoted as potential approaches to furthering the equity, access, and quality of recipient healthcare [2]. Both economics theory [3] and a large body of literature support the relationship between insurance coverage and access to care [4,5,6] as well as satisfaction with the care experience [7,8,9]. Improved insurance coverage would better support the attainment of three goals: development of reliable sources of care for each individual, expansion of access to medical, dental and vision care, and improvement of patient satisfaction within each care area [12]. Previous studies have found a positive relationship between expansion in

Methods

Results

Conclusion