Healthcare Expenditures among the Elderly in China: The Role of Catastrophic Medical Insurance

Hongmei Cao, Xinpeng Xu (), Hua You (), Jinghong Gu, Hongyan Hu and Shan Jiang
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Hongmei Cao: Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, China
Xinpeng Xu: Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing 211166, China
Hua You: Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing 211166, China
Jinghong Gu: College of Art and Sciences, University of Washington, 1400 NE Campus Parkway, Seattle, WA 98105, USA
Hongyan Hu: Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, China
Shan Jiang: Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing 210008, China

IJERPH, 2022, vol. 19, issue 21, 1-20

Abstract: China has been piloting the catastrophic medical insurance (CMI) program since 2012 and rolled it out nationally in 2016 to reduce the incidence of catastrophic health expenditure among Chinese residents. Few studies have been conducted to determine its effect on healthcare expenditures, particularly among the elderly. The purpose of this study is to examine the effect of CMI on healthcare expenditures among China’s elderly population. The data for this study were derived from 4 waves of the Chinese Longitudinal Healthy Longevity Survey, which included 344 and 1199 individuals in the treatment and control groups, respectively. To examine the effect of CMI on healthcare expenditures among the elderly, we used difference-in-differences and fixed-effects models. Additionally, a heterogeneity analysis was used to examine the differences in the impact of CMI on different groups. Finally, we confirmed the robustness of the results using robustness and placebo tests. CMI increased total health and out-of-pocket expenditures significantly, as well as inpatient and corresponding out-of-pocket expenditures. The reassults of the heterogeneity analysis indicated that CMI had a greater impact on elderly residents of rural areas. Economic burden protection has been enhanced for low-income groups and patients with serious diseases over the last two years. Our research indicated that CMI can promote the use of inpatient medical services for the elderly to a certain extent. Targeted measures such as expanding the CMI compensation list, establishing a more precise compensation scheme, and specific diseases associated with high healthcare expenditures can be considered in the practice of CMI implementation.

Keywords: healthcare expenditure; catastrophic medical insurance; the elderly; China (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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