Does the universal medical insurance system reduce catastrophic health expenditure among middle-aged and elderly households in China? A longitudinal analysis

Yue Zhou, Haishaerjiang Wushouer, Daniel Vuillermin, Xiaodong Guan () and Luwen Shi
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Yue Zhou: Peking University
Haishaerjiang Wushouer: Peking University
Daniel Vuillermin: Peking University
Xiaodong Guan: Peking University
Luwen Shi: Peking University

The European Journal of Health Economics, 2021, vol. 22, issue 3, No 10, 463-471

Abstract: Abstract Background The Chinese government has made great progress in establishing the universal medical insurance system. This study aimed to analyze whether the universal medical insurance system protected middle-aged and elderly households from catastrophic health expenditure (CHE). Methods The data were obtained from the China Health and Retirement Longitudinal Study. We used household as our unit of analysis and CHE was measured as out-of-pocket expenditures ≥ 40% of nonfood household expenditures. Univariate analysis was deployed to examine the impacts of different medical insurance schemes on CHE, and the factors associated with CHE were estimated using a random-effects logit regression model. Results We identified 10,005, 10,370, and 11,567 households in 2011, 2013, and 2015, respectively, and found 12.9% (2011), 26.6% (2013) and 27.9% (2015) of the households experienced CHE. When compared with no insurance, households enrolled in New Rural Cooperative Medical Insurance Scheme (P = 0.023) were associated with a lower incidence of CHE, but other insurance schemes were not significant. Households with members older than 65 years (P

Keywords: Catastrophic health expenditure; Medical insurance schemes; Middle-aged and elderly households; Out-of-pocket expenditures; Health insurance coverage (search for similar items in EconPapers)
JEL-codes: I14 (search for similar items in EconPapers)
Date: 2021
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Citations: View citations in EconPapers (4)

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DOI: 10.1007/s10198-021-01267-3

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