ArticleBMC health services research2020
Medical insurance and health equity in health service utilization among the middle-aged and older adults in China: a quantile regression approach.
Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 38 citations in OpenAlex.
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- Navigating life after gastric cancer surgery: a qualitative exploration of the dyadic patient-caregiver perspective on quality of life outcomes.BMC cancer · 2025Article
- Utilization of upper gastrointestinal tumor inpatient services affected by COVID-19 in China 2018-2021: an interrupted time series analysis.Frontiers in public health · 2025Article
- Mental health service readiness in Nepal: Insights from the 2021 Nepal Health Facility Survey.PLOS mental health · 2025Article
- Association of multimorbidity patterns with potential out-of-hospital clinical service needs: results from a nationally representative sample of older Chinese.Frontiers in public health · 2025Article
- The impact of personal medical savings accounts on healthcare utilization and out-of-pocket costs in public basic health insurance: a national cross-sectional study.Frontiers in public health · 2025Article
- Social security coverage and related factors in Mexican older adults: Analysis of three national surveys from the Mexican Health and Aging Study.Advances in public health · 2025Article
- The impact of an innovative payment method on medical expenditure, efficiency, and quality for inpatients with different types of medical insurance: evidence from a pilot city, China.International journal for equity in health · 2024Article
- A potential pathway for identifying hypertension among urban residents aged 60+ years in China: the role of health insurance.Frontiers in public health · 2024Article
- The impact of medical insurance on family financial support: evidence from CHARLS in China.Health economics review · 2023Article
- Inequality of opportunity in health service utilization among middle-aged and elderly community-dwelling adults in China.Archives of public health = Archives belges de sante publique · 2023Article
- Self-Medication Behaviors of Chinese Residents and Consideration Related to Drug Prices and Medical Insurance Reimbursement When Self-Medicating: A Cross-Sectional Study.International journal of environmental research and public health · 2022Article
- Socioeconomic inequality in public satisfaction with the healthcare system in China: a quantile regression analysis.Archives of public health = Archives belges de sante publique · 2022Article
- The Comparison of Various Types of Health Insurance in the Healthcare Utilization, Costs and Catastrophic Health Expenditures among Middle-Aged and Older Chinese Adults.International journal of environmental research and public health · 2022Article
- How does the Internet enhance the subjective well-being of elderly individuals in China?Frontiers in psychology · 2022Article
- Utilization and out-of-pocket expenses of primary care among the multimorbid elderly in China: A two-part model with nationally representative data.Frontiers in public health · 2022Article
- Care willingness and demand of residents under 60 years of age in western China: a cross-sectional study.BMJ open · 2021Article
- Trends and Age-Period-Cohort Effects on the Prevalence, Incidence and Mortality of Hepatocellular Carcinoma from 2008 to 2017 in Tianjin, China.International journal of environmental research and public health · 2021Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundChina has achieved nearly universal coverage of the Social Basic Medical Insurance (SBMI), which aims to reduce the disease burden and improve the utilization of health services. We investigated the association between China's health insurance schemes and health service utilization of middle-aged and older adults at different quantiles, and then explored whether the SBMI could help reduce the underutilization of health services among the middle-aged and older adults in China.
methodsSurvey data of middle-aged and older adults were drawn from the China Health and Retirement Longitudinal Study (CHARLS). A linear quantile mixed regression model was utilized to provide a comprehensive understanding of the relationship between SBMI and health service utilization, which was measured by the total medical expenditure. We took the New Rural Cooperative Medical Scheme (NCMS) as the reference level and examined the associations of the Urban Employee Basic Medical Insurance (UEBMI) and the Urban Resident Basic Medical Insurance (URBMI) with health service utilization.
resultsThe quantile regression analysis revealed a significant positive association between URBMI and health service utilization at the 0.75 (β = 1.608, p < 0.01), 0.8 (β = 1.578, p < 0.01), 0.85 (β = 1.473, p < 0.01), 0.9 (β = 1.403, p < 0.01) and 0.95 (β = 1.152, p < 0.01) quantiles, and also a significant positive association between UEBMI and health service utilization at the 0.85 (β = 1.196, p < 0.01), 0.9 (β = 1.070, p < 0.01) and 0.95 (β = 0.736, p < 0.01) quantiles. Results showed that URBMI was significantly associated with an improvement in inpatient health service utilization of the middle-aged and older adults, and a significant positive association between UEBMI and inpatient health service utilization was observed at 0.1 (β = 0.559, p < 0.01), 0.25 (β = 0.420, p < 0.05), 0.5 (β = 0.352, p < 0.05), and 0.75 (β = 0.306, p < 0.05) quantiles.
conclusionsInequity in health service utilization exists among the middle-aged and older adults across urban and rural Chinese areas, and it can be explained by the different reimbursement benefits of SBMI types.
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