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

Author

Listed:
  • Yue Zhou

    (Peking University)

  • Haishaerjiang Wushouer

    (Peking University
    Peking University)

  • Daniel Vuillermin

    (Peking University)

  • Xiaodong Guan

    (Peking University
    Peking University)

  • Luwen Shi

    (Peking University
    Peking University)

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

Suggested Citation

  • Yue Zhou & Haishaerjiang Wushouer & Daniel Vuillermin & Xiaodong Guan & Luwen Shi, 2021. "Does the universal medical insurance system reduce catastrophic health expenditure among middle-aged and elderly households in China? A longitudinal analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(3), pages 463-471, April.
    • Handle: RePEc:spr:eujhec:v:22:y:2021:i:3:d:10.1007_s10198-021-01267-3
    DOI: 10.1007/s10198-021-01267-3
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    Cited by:

    1. Aleksandra Kolasa & Ewa Weychert, 2024. "The causal effect of catastrophic health expenditure on poverty in Poland," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(2), pages 193-206, March.
    2. Deng, Yuanyuan & Fang, Hanming & Hanewald, Katja & Wu, Shang, 2023. "Delay the Pension Age or Adjust the Pension Benefit? Implications for Labor Supply and Individual Welfare in China," Journal of Economic Behavior & Organization, Elsevier, vol. 212(C), pages 1192-1215.
    3. 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.
    4. Wen He, 2022. "Effects of establishing a financing scheme for outpatient care on inpatient services: empirical evidence from a quasi-experiment in China," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(1), pages 7-22, February.

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    More about this item

    Keywords

    Catastrophic health expenditure; Medical insurance schemes; Middle-aged and elderly households; Out-of-pocket expenditures; Health insurance coverage;
    All these keywords.

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality

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