Medical insurance and healthcare utilization among the middle-aged and elderly in China: evidence from the China health and retirement longitudinal study 2011, 2013 and 2015
Medical insurance and healthcare utilization among the middle-aged and elderly in China: evidence from the China health and retirement longitudinal study 2011, 2013 and 2015
复制标题
中国中老年人的医疗保险和医疗保健利用：来自2011年、2013年和2015年中国健康与退休纵向研究的证据
DOI：
10.1186/s12913-020-05522-w
复制
发表时间：
2020-07-14
影响因子：
2.8
通讯作者：
Shi, Luwen
中科院分区：
文献类型：
--
作者：
Zhou, Yue;Wushouer, Haishaerjiang;Shi, Luwen
背景为了应对中国迅速老龄化的人口和日益增长的医疗服务需求，中国政府正在发展全民医疗保险制度。本研究旨在评估我国中老年人的医疗利用模式，分析医疗保险制度对中老年人医疗利用的影响。方法数据来源于2011年、2013年和2015年的中国健康与退休纵向研究。医疗服务利用率通过门诊和住院服务利用率来衡量。采用单变量分析来检验不同医疗保险计划对医疗保健利用率的影响。结果在研究期间，参与人数分别为17250人、18195人和19842人。门诊就诊率分别为18.6%、20.7%和18.7%，住院就诊率分别为9.6%、13.8%和14.3%。我们发现，医疗保险是提高医疗服务利用率的主要保障因素，但不同的医疗保险制度对中老年人的影响是不同的。结论在人口覆盖率不断扩大的情况下，中国政府应该尽一切努力缩小不同医疗保险制度的人群之间的差距。需要进一步评估扩大的医疗保险计划是否能够保护中老年家庭免受灾难性的医疗支出的影响。
BackgroundIn response to China's rapidly aging population and increasing healthcare service demands, the Chinese government is developing a universal medical insurance system. This study aimed to assess healthcare utilization patterns and analyze the impacts of medical insurance schemes on healthcare utilization among the middle-aged and elderly in China.MethodsData was extracted from the China Health and Retirement Longitudinal Study in 2011, 2013 and 2015. Healthcare utilization was measured by outpatient and inpatient service utilization. Univariate analysis was deployed to examine the impacts of different medical insurance schemes on healthcare utilization. The factors associated with healthcare utilization were estimated using a random-effects logistic regression model.ResultsDuring the study period, the number of individuals involved was 17,250, 18,195 and 19,842, respectively. The proportion of individuals who received outpatient service was 18.6, 20.7 and 18.7% and those who used inpatient service was 9.6, 13.8 and 14.3%, respectively. We identified that medical insurance was a major protective factor for improving healthcare utilization but different medical insurance schemes exerted various impacts on the middle-aged and the elderly.ConclusionsDespite the growing population coverage, the Chinese government should make every effort to bridge the gap among people with different medical insurance schemes. Further evaluation is needed to assess whether the expanded medical insurance schemes could protect the middle-aged and elderly households from catastrophic health expenditure.