IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v357y2024ics0277953624006166.html
   My bibliography  Save this article

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

Author

Listed:
  • 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
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953624006166
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2024.117163?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    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. 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.
    3. 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.
    4. 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.
    5. 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.
    6. 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.
    7. 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).
    8. 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.
    9. 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).
    10. 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).
    11. Dong, Keyong, 2009. "Medical insurance system evolution in China," China Economic Review, Elsevier, vol. 20(4), pages 591-597, December.
    12. 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.
    13. Juan M. Villa, 2016. "diff: Simplifying the estimation of difference-in-differences treatment effects," Stata Journal, StataCorp LP, vol. 16(1), pages 52-71, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. He, Wen, 2023. "Social medical insurance integration and health care disparities in China: Evidence from an administrative claim dataset," Economic Analysis and Policy, Elsevier, vol. 79(C), pages 20-39.
    2. Wei Si, 2021. "Public health insurance and the labor market: Evidence from China's Urban Resident Basic Medical Insurance," Health Economics, John Wiley & Sons, Ltd., vol. 30(2), pages 403-431, February.
    3. Li, Yao & Li, Lei & Liu, Junxia, 2023. "The efficient moral hazard effect of health insurance: Evidence from the consolidation of urban and rural resident health insurance in China," Social Science & Medicine, Elsevier, vol. 324(C).
    4. Hai Zhong, 2011. "Effect of patient reimbursement method on health‐care utilization: evidence from China," Health Economics, John Wiley & Sons, Ltd., vol. 20(11), pages 1312-1329, November.
    5. Cheung, Diana & Padieu, Ysaline, 2015. "Heterogeneity of the Effects of Health Insurance on Household Savings: Evidence from Rural China," World Development, Elsevier, vol. 66(C), pages 84-103.
    6. Nikolov, Plamen & Hossain, Md Shahadath, 2023. "Do pension benefits accelerate cognitive decline in late adulthood? Evidence from rural China," Journal of Economic Behavior & Organization, Elsevier, vol. 205(C), pages 594-617.
    7. Lin, Lin & Zai, Xianhua, 2022. "The Power of Public Insurance With Limited Benefits: Evidence from China's New Cooperative Medical Scheme," GLO Discussion Paper Series 1180, Global Labor Organization (GLO).
    8. Jens Hougaard & Lars Østerdal & Yi Yu, 2011. "The Chinese healthcare system," Applied Health Economics and Health Policy, Springer, vol. 9(1), pages 1-13, January.
    9. Feng, Jin & Song, Hong & Wang, Zhen, 2020. "The elderly's response to a patient cost-sharing policy in health insurance: Evidence from China," Journal of Economic Behavior & Organization, Elsevier, vol. 169(C), pages 189-207.
    10. Lu Chen & Miaoting Cheng, 2022. "Exploring Chinese Elderly’s Trust in the Healthcare System: Empirical Evidence from a Population-Based Survey in China," IJERPH, MDPI, vol. 19(24), pages 1-16, December.
    11. Giulia Bettin & Isabella Giorgetti & Stefano Staffolani, 2024. "The impact of Covid-19 lockdown on the gender gap in the Italian labour market," Review of Economics of the Household, Springer, vol. 22(1), pages 1-33, March.
    12. Cristina Fernandez & Leonardo Villar, 2017. "The Impact of Lowering the Payroll Tax on Informality in Colombia," Economía Journal, The Latin American and Caribbean Economic Association - LACEA, vol. 0(Fall 2017), pages 125-155, November.
    13. Guangsheng Wan & Zixuan Peng & Yufeng Shi & Peter C. Coyte, 2020. "What Are the Determinants of the Decision to Purchase Private Health Insurance in China?," IJERPH, MDPI, vol. 17(15), pages 1-15, July.
    14. Huijie Yan, 2015. "The Integration of Energy, Environment and Health Policies in China: A Review," Working Papers halshs-01247183, HAL.
    15. Chen, Yi & Shi, Julie & Zhuang, Castiel Chen, 2019. "Income-dependent impacts of health insurance on medical expenditures: Theory and evidence from China," China Economic Review, Elsevier, vol. 53(C), pages 290-310.
    16. Bai, Jin & Li, Hua, 2024. "Effects of urban-rural medical insurance integration on health: Evidence from rural China," Journal of Asian Economics, Elsevier, vol. 92(C).
    17. Zhang, Xuan & Nie, Huihua, 2021. "Public health insurance and pharmaceutical innovation: Evidence from China," Journal of Development Economics, Elsevier, vol. 148(C).
    18. repec:dem:wpaper:wp-2022-025 is not listed on IDEAS
    19. Leonardo M. Giuffrida & Gabriele Rovigatti, 2022. "Supplier selection and contract enforcement: Evidence from performance bonding," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 31(4), pages 980-1019, November.
    20. Liu, Chen & Yang, Wei, 2023. "Does social insurance stimulate business creation? Evidence from China," Pacific-Basin Finance Journal, Elsevier, vol. 79(C).
    21. Nikolov, Plamen & Adelman, Alan, 2020. "Pension Policies, Retirement and Human Capital Depreciation in Late Adulthood," IZA Discussion Papers 13932, Institute of Labor Economics (IZA).

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:357:y:2024:i:c:s0277953624006166. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.