Income-related benefit mobility before and after Urban and Rural Resident Basic Medical Insurance integration: a longitudinal analysis of China
- Yongjian Xu 1, Yazhuo Liu 1, Hui Li 1, Ruirui Guo 1, Jiaxin Sun 1, Zhongliang Zhou 1, Jie Ma 2
- Yongjian Xu 1, Yazhuo Liu 1, Hui Li 1
- 1School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China.
- 2Jinhe Center for Economic Research, Xi'an Jiaotong University, Xi'an, 710049, China. jiema_xjtu@126.com.
- 0School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China.
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View abstract on PubMed
Summary
This summary is machine-generated.China
Area Of Science
- Health Economics
- Public Health Policy
- Social Equity in Healthcare
Background
- The Chinese government unified two major medical insurance schemes into the Urban and Rural Resident Basic Medical Insurance system (URRBMI).
- This integration aimed to enhance equity in medical insurance benefits for all residents.
- Previous disparities existed between rural and nonworking urban residents' insurance coverage.
Purpose Of The Study
- To assess changes in income-related mobility of medical insurance benefits post-URRBMI integration.
- To evaluate the impact of the URRBMI integration on healthcare equity.
- To identify specific areas of benefit improvement or disparity.
Main Methods
- Utilized panel data from the 2011 and 2018 China Health and Retirement Longitudinal Study (9,662 participants).
- Analyzed four benefit indicators (benefit rate, probability, compensation, reimbursement) for outpatient and inpatient care.
- Employed the concentration index (CI) to measure income-related inequality and decomposed changes to assess mobility effects.
Main Results
- All medical insurance benefit measures significantly increased post-integration, except for outpatient benefit probability and inpatient reimbursement probability.
- Concentration indices shifted from positive to negative, indicating reduced inequality (e.g., benefit rate: 0.129 to -0.052).
- Positive income-related mobility was observed for inpatient care benefits, but outpatient benefit mobility showed no significant change.
Conclusions
- The URRBMI integration successfully narrowed income-related inequalities in medical insurance, particularly for inpatient care.
- The reform has demonstrably contributed to a more equitable healthcare system in China.
- Further enhancements are recommended to improve outpatient benefit coverage within the URRBMI scheme.
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