ArticleInternational journal for equity in health2021
The benefits of an integrated social medical insurance for health services utilization in rural China: evidence from the China health and retirement longitudinal study.
Article in International journal for equity in health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed.
- Medical insurance integration and rural-urban benefit disparities, 2006-2021: evidence from quasi-natural experiments in China.BMJ open · 2025Article
- Medical insurance integration and spatial effects in China: evidence from quasi-natural experiments and linked administrative data.BMC health services research · 2025Article
- Income-related benefit mobility before and after Urban and Rural Resident Basic Medical Insurance integration: a longitudinal analysis of China.BMC health services research · 2025Article
- Potential causal associations of long-term exposure to PMEcotoxicology and environmental safety · 2025Article
- How do Chinese people perceive their healthcare system? Inequality in public satisfaction with healthcare security.Frontiers in public health · 2025Article
- Factors influencing intentional non-utilization of healthcare: a study using the Andersen model.Frontiers in public health · 2025Article
- Multilevel medical insurance mitigate health cost inequality due to air pollution: Evidence from China.International journal for equity in health · 2024Article
- Decomposition analysis on the equity of health examination utilization for the middle-aged and elderly people in China: based on longitudinal CHARLS data from 2011 to 2018.BMC public health · 2024Article
- The Nexus Between Medical Care Policy Alienation and Career Success: A Cross-Sectional Study.Journal of nursing management · 2024Article
- Barriers to rural women's participation in social insurance for farmers, villagers, and nomads: the case of Iran.Frontiers in sociology · 2024Article
- Eliciting medication preferences of patients with type 2 diabetes under different insurance coverages in China.Frontiers in public health · 2024Article
- Inequalities changes in health services utilization among middle-aged and older adult disabled people in China: based on CHARLS 2011-2018.Frontiers in public health · 2024Article
- Trends in health service needs, utilization, and non-communicable chronic diseases burden of older adults in China: evidence from the 1993 to 2018 National Health Service Survey.International journal for equity in health · 2023Article
- Analysing the global and local spatial associations of medical resources across Wuhan city using POI data.BMC health services research · 2023Article
- Does basic medical insurance promote public health? Evidence from China family panel study.Frontiers in public health · 2023Article
- Effects of Urban and Rural Resident Basic Medical Insurance on Healthcare Utilization Inequality in China.International journal of public health · 2023Article
- Horizontal Integration and Financing Reform of Rural Primary Care in China: A Model for Low-Resource and Remote Settings.International journal of environmental research and public health · 2022Article
- The healthcare inequality among middle-aged and older adults in China: a comparative analysis between the full samples and the homogeneous population.Health economics review · 2022Article
- Can Basic Medical Insurance Reduce Elderly Family Income Inequality in China?Frontiers in public health · 2022Article
- Rural residents' willingness to participate in basic medical insurance and influential factors: A survey of three provinces in China.Frontiers in public health · 2022Article
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5 authors.
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Abstract
backgroundImproving health equity is a fundamental goal for establishing social health insurance. This article evaluated the benefits of the Integration of Social Medical Insurance (ISMI) policy for health services utilization in rural China.
methodsUsing the China Health and Retirement Longitudinal study (2011‒2018), we estimated the changes in rates and equity in health services utilization by a generalized linear mixed model, concentration curves, concentration indices, and a horizontal inequity index before and after the introduction of the ISMI policy.
resultsFor the changes in rates, the generalized linear mixed model showed that the rate of inpatient health services utilization (IHSU) nearly doubled after the introduction of the ISMI policy (8.78 % vs. 16.58 %), while the rate of outpatient health services utilization (OHSU) decreased (20.25 % vs. 16.35 %) after the implementation of the policy. For the changes in inequity, the concentration index of OHSU decreased significantly from - 0.0636 (95 % CL: -0.0846, - 0.0430) before the policy to - 0.0457 (95 % CL: -0.0684, - 0.0229) after it. In addition, the horizontal inequity index decreased from - 0.0284 before the implementation of the policy to - 0.0171 after it, indicating that the inequity of OHSU was further reduced. The concentration index of IHSU increased significantly from - 0.0532 (95 % CL: -0.0868, - 0.0196) before the policy was implemented to - 0.1105 (95 % CL: -0.1333, - 0.0876) afterwards; the horizontal inequity index of IHSU increased from - 0.0066 before policy implementation to - 0.0595 afterwards, indicating that more low-income participants utilized inpatient services after the policy came into effect.
conclusionsThe ISMI policy had a positive effect on improving the rate of IHSU but not on the rate of OHSU. This is in line with this policy's original intention of focusing on inpatient service rather than outpatients to achieve its principal goal of preventing catastrophic health expenditure. The ISMI policy had a positive effect on reducing the inequity in OHSU but a negative effect on the decrease in inequity in IHSU. Further research is needed to verify this change. This research on the effects of integration policy implementation may be useful to policy makers and has important policy implications for other developing countries facing similar challenges on the road to universal health coverage.
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