Dataset Information

Health insurance utilization and its impact: observations from the middle-aged and elderly in China.

ABSTRACT:

Objective

In China, despite a high coverage rate, health insurance is not used for all illness episodes. Our goal is to identify subjects' characteristics associated with insurance utilization and the association between utilization and medical expenditure.

Methods

A survey was conducted in January and February of 2012. 2093 middle-aged and elderly subjects (45 years old and above) were surveyed.

Results

Heath insurance was not utilized for 12.6% (inpatient), 53.3% (outpatient), and 72.6% (self-treatment) of disease episodes. Subjects' characteristics were associated with insurance utilization. Inpatient and outpatient treatments were expensive. In the multivariate analysis of outpatient treatment expenditure, insurance utilization was significantly associated with higher treatment cost, lost income, and gross total cost.

Conclusion

Utilization of health insurance may need to be improved. Insurance utilization can reduce out-of-pocket medical expenditure. However, the amount paid by the insured is still high. Policy intervention is needed to further improve the effectiveness of health insurance.

SUBMITTER: Wang Y

PROVIDER: S-EPMC3855696 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Health insurance utilization and its impact: observations from the middle-aged and elderly in China.

Wang Yu Y Jiang Yan Y Li Yang Y Wang Xiaojun X Ma Chi C Ma Shuangge S

PloS one 20131206 12

<h4>Objective</h4>In China, despite a high coverage rate, health insurance is not used for all illness episodes. Our goal is to identify subjects' characteristics associated with insurance utilization and the association between utilization and medical expenditure.<h4>Methods</h4>A survey was conducted in January and February of 2012. 2093 middle-aged and elderly subjects (45 years old and above) were surveyed.<h4>Results</h4>Heath insurance was not utilized for 12.6% (inpatient), 53.3% (outpati ...[more]

PMID: 24324654

Similar Datasets

Project description: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 (??=?1.608, p?<?0.01), 0.8 (??=?1.578, p?<?0.01), 0.85 (??=?1.473, p?<?0.01), 0.9 (??=?1.403, p?<?0.01) and 0.95 (??=?1.152, p?<?0.01) quantiles, and also a significant positive association between UEBMI and health service utilization at the 0.85 (??=?1.196, p?<?0.01), 0.9 (??=?1.070, p?<?0.01) and 0.95 (??=?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 (??=?0.559, p?<?0.01), 0.25 (??=?0.420, p?<?0.05), 0.5 (??=?0.352, p?<?0.05), and 0.75 (??=?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.

Project description:BackgroundMultimorbidity has become one of the main challenges in health care system. The association between prevalence, patterns of multimorbidity and health care utilization is less often discussed in China. The purpose of this study is to examine this association among Chinese middle-aged and older adults and take into account different sociodemographic, behavioral and health characteristics. Based on this, implications of current evidence and effective intervention on multimorbidity and health care utilization can be identified and put into practice.MethodsThe wave 4 in 2018 of the China Health and Retirement Longitudinal Study (CHARLS) was used in the study. Multimorbidity was defined as the co-occurrence of two or more chronic medical condition of a list of fourteen chronic diseases in one person. The presence of chronic diseases was assessed through self-report. Health care utilization include whether the respondents received outpatient service last month and inpatient service in the past year. Latent Class Analysis was conducted to identify the clustering pattern of chronic diseases. Logistic regressions were employed to explore the association between prevalence, patterns of multimorbidity and health care utilization. Analyses were weighted using individual sample weights, adjusted for non-response of individual and household.ResultsAmong 19,559 participants aged 45 and older, 23.10% were aged above 70 years and 52.42% were female. The prevalence of multimorbidity was 56.73%. Four patterns were identified: relatively healthy class, respiratory class, stomach-arthritis class and vascular class. Multimorbid individuals used more outpatient services (OR = 1.89, 95%CI = 1.65-2.17) and more inpatient services (OR = 2.52, 95%CI = 2.22-2.86) compared to their no-multimorbid counterparts. Compared to relatively healthy class, the respondents classified into respiratory class, stomach-arthritis class and vascular class used more outpatient services (OR = 1.90, 95%CI = 1.57-2.30; OR = 2.39, 95%CI = 2.06-2.78; OR = 1.53, 95%CI = 1.32-1.79 respectively) and more inpatient services (OR = 2.19, 95%CI = 1.83-2.62; OR = 2.93, 95%CI = 2.53-3.40; OR = 1.90, 95%CI = 1.65-2.19 respectively).ConclusionOur study provided evidence that multimorbidity is high among Chinese older adults and is associated substantially higher health care utilization in China. Four multimorbidity patters were identified. Policy should prioritize improving the management of individuals with multimorbidity to increase healthcare efficiency. Further research is necessary with special emphasis on the trajectory of multimorbidity and the role of health system in satisfying needs of multimorbid individuals.

Dataset Information

Health insurance utilization and its impact: observations from the middle-aged and elderly in China.

Objective

Methods

Results

Conclusion

Publications

Health insurance utilization and its impact: observations from the middle-aged and elderly in China.

Similar Datasets

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