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Impact of medical insurance integration on reducing urban-rural health disparity: Evidence from China

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  • Tang, Yingqian
  • Fu, Rong
  • Noguchi, Haruko

Abstract

The urban-rural health disparity poses a significant challenge for countries worldwide. China encounters substantial disparities in healthcare services and health outcomes between urban and rural regions. In 2015, the Chinese government integrated the medical insurance schemes for urban and rural residents into a unified program, with the goal of mitigating the disparities and enhancing the sustainability and efficiency of the medical insurance system. Using data from the China Health and Retirement Longitudinal Study (CHARLS), we explored the impact of this integration on health outcomes and the health disparity between urban and rural residents, employing a triple difference approach with propensity score matching. We found that both urban and rural residents benefited from the medical insurance reform, experiencing improvements in their health outcomes to some extent. Urban residents reported better self-reported health, while rural residents exhibited improved health in terms of both self-reported health and number of diagnosed diseases. Notably, the disparity in activities of daily living (ADL) difficulties decreased. However, we also observed a worsening trend in ADL difficulties, especially among the elderly and the working population. This underscores the urgent need for further attention to health behaviors and healthcare resource allocation to these socio-demographic groups.

Suggested Citation

  • Tang, Yingqian & Fu, Rong & Noguchi, Haruko, 2024. "Impact of medical insurance integration on reducing urban-rural health disparity: Evidence from China," Social Science & Medicine, Elsevier, vol. 357(C).
  • Handle: RePEc:eee:socmed:v:357:y:2024:i:c:s0277953624006166
    DOI: 10.1016/j.socscimed.2024.117163
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    References listed on IDEAS

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    1. Shaoda Wang & David Y. Yang, 2021. "Policy Experimentation in China: the Political Economy of Policy Learning," NBER Working Papers 29402, National Bureau of Economic Research, Inc.
    2. Feng Huang & Li Gan`, 2017. "The Impacts of China's Urban Employee Basic Medical Insurance on Healthcare Expenditures and Health Outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 26(2), pages 149-163, February.
    3. David H. Autor, 2003. "Outsourcing at Will: The Contribution of Unjust Dismissal Doctrine to the Growth of Employment Outsourcing," Journal of Labor Economics, University of Chicago Press, vol. 21(1), pages 1-42, January.
    4. Lei, Xiaoyan & Bai, Chen & Hong, Jingpeng & Liu, Hong, 2022. "Long-term care insurance and the well-being of older adults and their families: Evidence from China," Social Science & Medicine, Elsevier, vol. 296(C).
    5. Yang, Di & Acharya, Yubraj & Liu, Xiaoting, 2022. "Social health insurance consolidation and urban-rural inequality in utilization and financial risk protection in China," Social Science & Medicine, Elsevier, vol. 308(C).
    6. Tan, Si Ying & Wu, Xun & Yang, Wei, 2019. "Impacts of the type of social health insurance on health service utilisation and expenditures: implications for a unified system in China," Health Economics, Policy and Law, Cambridge University Press, vol. 14(4), pages 468-486, October.
    7. Andreas Olden & Jarle Møen, 2022. "The triple difference estimator [Semiparametric difference-in-differences estimators]," The Econometrics Journal, Royal Economic Society, vol. 25(3), pages 531-553.
    8. Hongmei Yi & Linxiu Zhang & Kim Singer & Scott Rozelle & Scott Atlas, 2009. "Health insurance and catastrophic illness: a report on the New Cooperative Medical System in rural China," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 119-127, July.
    9. Qin Zhou & Qing He & Karen Eggleston & Gordon G Liu, 2022. "Urban-rural health insurance integration in china: impact on health care utilization, financial risk protection, and health status," Applied Economics, Taylor & Francis Journals, vol. 54(22), pages 2491-2509, May.
    10. Wanchuan Lin & Gordon G. Liu & Gang Chen, 2009. "The Urban Resident Basic Medical Insurance: a landmark reform towards universal coverage in China," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 83-96, July.
    11. Huang, Xian & Wu, Bingxiao, 2020. "Impact of urban-rural health insurance integration on health care: Evidence from rural China," China Economic Review, Elsevier, vol. 64(C).
    12. Dong, Keyong, 2009. "Medical insurance system evolution in China," China Economic Review, Elsevier, vol. 20(4), pages 591-597, December.
    13. Juan M. Villa, 2016. "diff: Simplifying the estimation of difference-in-differences treatment effects," Stata Journal, StataCorp LLC, vol. 16(1), pages 52-71, March.
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