ArticleBMC health services research2026
Catastrophic health expenditure and commercial health insurance purchase: evidence from China.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn China, catastrophic health expenditure (CHE) is a predominant factor that drives households into poverty. While commercial health insurance (CHI) can mitigate the adverse consequences of CHE, its uptake remains limited. This study aimed to analyse the association between CHE and the purchase of CHI in China from an ex post perspective.
methodsThis study included 34,534 observations from data from the 2019 China Household Finance Survey. A two-part model was employed to analyse the association between CHE (categorized as none, mild, moderate, or severe) and individual CHI purchase (both purchase behaviour and premium expenditure), guided by an integrated framework. Subgroup analyses were conducted to compare factors influencing CHI purchase between observations with and without household CHE.
resultsThe prevalence rates of mild, moderate, and severe CHE were 19.27%, 6.97%, and 6.89%, respectively. The overall CHI purchase rate was 4.48%. Severe CHE was negatively associated with the likelihood of purchasing CHI (OR = 0.475, p < 0.01), whereas moderate CHE was negatively associated with premium expenditure among purchasers (coef.=−1.227, p < 0.05). Ambiguous risk preference was negatively associated with both the likelihood of purchasing CHI and premium expenditure. Factors such as poor self-rated health, older age (≥65 years), male sex, and lack of financial attention were negatively associated with the likelihood of purchasing CHI. Greater educational attainment and a stronger social support network were positively associated with the likelihood of purchasing CHI. Subgroup analyses revealed that the influencing factors of CHI purchase systematically differed between observations with and without household CHE.
conclusionsCHE is negatively associated with CHI purchase. The government should establish a full-cycle risk protection mechanism for vulnerable groups by deepening health care reform, implementing targeted subsidies, and enhancing public awareness. It is equally important for insurance institutions to improve the accessibility of CHI.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.