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Health Insurance Utilization and Its Impact: Observations from the Middle-Aged and Elderly in China

Author

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  • Yu Wang
  • Yan Jiang
  • Yang Li
  • Xiaojun Wang
  • Chi Ma
  • Shuangge Ma

Abstract

Objective: In China, despite a high coverage rate, health insurance is not used for all illness episodes. Our goal is to identify subjects’ characteristics associated with insurance utilization and the association between utilization and medical expenditure. Methods: A survey was conducted in January and February of 2012. 2093 middle-aged and elderly subjects (45 years old and above) were surveyed. Results: Heath insurance was not utilized for 12.6% (inpatient), 53.3% (outpatient), and 72.6% (self-treatment) of disease episodes. Subjects’ characteristics were associated with insurance utilization. Inpatient and outpatient treatments were expensive. In the multivariate analysis of outpatient treatment expenditure, insurance utilization was significantly associated with higher treatment cost, lost income, and gross total cost. Conclusion: Utilization of health insurance may need to be improved. Insurance utilization can reduce out-of-pocket medical expenditure. However, the amount paid by the insured is still high. Policy intervention is needed to further improve the effectiveness of health insurance.

Suggested Citation

  • Yu Wang & Yan Jiang & Yang Li & Xiaojun Wang & Chi Ma & Shuangge Ma, 2013. "Health Insurance Utilization and Its Impact: Observations from the Middle-Aged and Elderly in China," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-9, December.
    • Handle: RePEc:plo:pone00:0080978
    DOI: 10.1371/journal.pone.0080978
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    Cited by:

    1. Zhaorong Gao & Lingzhong Xu & Wenzhe Qin & Jiao Zhang & Jinling Zhou & Fangfang Hu & Zhuang Hong, 2020. "Prevalence and Associated Factors of Self-Treatment among the Elderly—A Comparative Study between Empty and Non-Empty Nesters in Shandong, China," IJERPH, MDPI, vol. 17(21), pages 1-11, October.
    2. Xiaotong Wen & Lanyue Cui & Fang Yuan & Xiaojun Liu & Mufeng Ouyang & Yuxiao Sun & Yuchen Liu & Yong Liu & Huiqiang Yu & Huilie Zheng & Yuanan Lu & Zhaokang Yuan, 2020. "Study on the Utilization of Inpatient Services for Middle-Aged and Elderly Rural Females in Less Developed Regions of China," IJERPH, MDPI, vol. 17(2), pages 1-18, January.
    3. Junfang Xu & Jian Wang & Madeleine King & Ruiyun Liu & Fenghua Yu & Jinshui Xing & Lei Su & Mingshan Lu, 2018. "Rural–urban disparities in the utilization of mental health inpatient services in China: the role of health insurance," International Journal of Health Economics and Management, Springer, vol. 18(4), pages 377-393, December.
    4. Yinjun Zhao & Bowei Kang & Yawen Liu & Yichong Li & Guoqing Shi & Tao Shen & Yong Jiang & Mei Zhang & Maigeng Zhou & Limin Wang, 2014. "Health Insurance Coverage and Its Impact on Medical Cost: Observations from the Floating Population in China," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-9, November.
    5. Rui Wang & Chenjin Ma & Kun Jiang & Ming Li & Shuangge Ma, 2018. "Descriptions of self-treatment for the middle-aged and elderly in Shanxi, China," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-14, June.
    6. Long Thanh Giang & Tham Hong Thi Pham & Phong Manh Phi & Nam Truong Nguyen, 2023. "Healthcare Services Utilisation and Financial Burden among Vietnamese Older People and Their Households," IJERPH, MDPI, vol. 20(12), pages 1-13, June.
    7. Yang Li & Yinjun Zhao & Danhui Yi & Xiaojun Wang & Yan Jiang & Yu Wang & Xinchun Liu & Shuangge Ma, 2017. "Differences exist across insurance schemes in China post-consolidation," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-13, November.

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