Abstract
BackgroundThe 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.MethodsThe 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.ResultsThe 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%.ConclusionsThe 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.
Highlights
The medical insurance system is an integral part of the national public health system [1]
Controli indicates other control variables, including range of migration, household income, personal economic source, number of friends, daily exercise time, physical examination status, inflowing provinces, etc. β3 indicates the influence of Regression results of the effect of the institutional difference in the medical insurance system on the equity of the utilization of health services by the floating elderly population As mentioned in the introduction, under the current medical insurance system in China, different medical insurance systems may have an impact on the utilization of health services by the floating elderly population population
Column (1) of Table 6 reports the impact of different medical insurance systems on the utilization of health services by the floating elderly; the treatment group is “Basic Medical Insurance System for Urban Employees (BMISUE)”, and the control group is “BMISURR.” The results show that the coefficient of the average treatment effect on the treated (ATT) is − 0.0344, and the
Summary
The medical insurance system is an integral part of the national public health system [1]. It helps reduce the burden of medical services for the insured by lowering the economic threshold for receiving medical services, thereby improving the health of the insured to a certain extent [2]. Since the implementation of the reform and opening up policy in the late 1970s, the Chinese government has built a system of universal medical insurance in a stepby-step manner [4]. The Chinese government has 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
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