The interaction effect of health insurance reimbursement and health workforce on health care‐seeking behaviour in China

Yinzi Jin, Beibei Yuan, Weiming Zhu, Yaoguang Zhang, Ling Xu and Qingyue Meng

International Journal of Health Planning and Management, 2019, vol. 34, issue 3, 900-911

Abstract: Objective In China, patients generally seek health care at high‐level hospitals, which is leading to escalating medical costs and overloaded hospitals. Some studies have suggested that the health system is an important factor influencing individuals' health care‐seeking behaviour; however, this association has not been studied in much depth. We therefore examined the impact of the health system (in terms of the interaction between health insurance reimbursement and health workforce) on health care‐seeking behaviour. Methods Drawing on national survey data from 2008 and 2013, we linked individual‐level data on choice of health care providers (our index of health care‐seeking behaviour) with county‐level data on the health workforce and health insurance. We then constructed a multilevel multinomial logistic model to examine the impacts of health insurance reimbursement (indexed as average reimbursement rate [ARR]) and the health workforce (number of registered physicians per 1000 population) at county hospitals and primary health care institutions (PHCs) on choice of inpatient care providers. Results Increases in ARR at county hospitals were associated with a greater probability of visiting such hospitals (relative risk ratio [RRR] = 1.23), and this positive impact was even greater in county hospitals with higher physician densities (RRR = 2.76). Greater ARR in PHCs was associated with a 73% lower probability of visiting municipal‐ and higher‐level hospitals; increasing ARR was associated with an even lower probability when physician density in PHCs was considered (RRR = 0.09). Conclusion Increases in the health insurance reimbursement and health workforce are necessary to improve health care access and thereby health care‐seeking behaviour. Thus, comprehensive health system reform is necessary.

Date: 2019
References: Add references at CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
https://doi.org/10.1002/hpm.2860

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:bla:ijhplm:v:34:y:2019:i:3:p:900-911

Ordering information: This journal article can be ordered from
http://www.blackwell ... bs.asp?ref=0749-6753

Access Statistics for this article

International Journal of Health Planning and Management is currently edited by Calum Paton

More articles in International Journal of Health Planning and Management from Wiley Blackwell
Bibliographic data for series maintained by Wiley Content Delivery ().