Factors influencing medical insurance participation and satisfaction among non-standard workers in China

Universal health coverage is the goal of China's healthcare system reform. However, with the growth of the gig economy, problems such as the failure of non-standard workers to participate in basic medical insurance continue to arise. Consequently, we investigated the factors that influence non-standard workers' medical insurance participation and satisfaction, with the goal of improving their participation.

This study collected data on insurance participation among non-standard workers through 635 questionnaire surveys. Based on Andersen's model and logistic regression analysis, this study examined the factors influencing their insurance enrollment and analyzed the satisfaction level with medical insurance policies among those who participated.

The majority of non-standard workers were young healthy men, whose utilization of health services was low. The coverage rate of basic medical insurance for non-standard workers was 38.4%, which is relatively low. Those who were young with a high monthly income, participated in commercial or other medical insurance, and self-rated their health status as good were inclined to opt out of basic medical insurance. Non-standard workers' satisfaction with the basic medical insurance policy was 2.5 points on average. Those who were male, highly educated, floating population members, lacked an understanding of the basic medical insurance policy, and self-rated their health status as poor were more likely to have low satisfaction with the basic medical insurance policy.

The insurance participation rate of non-standard workers needs to be improved. To do so, it is necessary to intensify the publicity concerning medical insurance policies; raise the awareness of non-standard workers, especially young healthy non-standard workers, about insurance; and improve the insurance policies of non-standard workers according to their industry particularities.