The impact of health insurance integration on patient choice of providers in China

Wenhui Xu and Cheng Huang

Applied Economics, 2025, vol. 57, issue 57, 9770-9787

Abstract: This paper utilizes a nationwide integration reform of two public health insurance programmes in China to examine the impact of health insurance integration on patient choice of medical providers. Using a dataset that combines longitudinal survey data and government regulations data, we find that the integration leads to an increasing probability of outpatients in nearby primary care facilities and decreased outpatient visits to public healthcare providers. Moreover, the effects of integration vary with patient demographics, the type of healthcare, and the model of insurance management. No significant evidence suggests that the integration affects health behaviours or health status in the short term. These findings provide empirical evidence on the effects of insurance integration and policy implications for building an efficient hierarchical healthcare system.

Date: 2025
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DOI: 10.1080/00036846.2024.2423899

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