Assessing the Impact of Public Insurance on Healthcare Utilization and Mortality: A Nationwide Study in China

Overview

Journal SSM Popul Health

Date 2024 Feb 7

PMID 38322784

Authors

Lin Lin

Xianhua Zai

Affiliations

Soon will be listed here.

Abstract

We investigate the effects of a significant health insurance expansion in rural China known as the New Cooperative Medical Scheme (NCMS). Our analysis is based on a nationwide dataset spanning from 2004 to 2011. We find that the NCMS effectively increases healthcare utilization, particularly inpatient admissions, and reduces the incidence for infectious diseases. In addition to the increased healthcare utilization, the reduction in the incidence for infectious diseases can be attributed to improved health knowledge and health behavior, both of which are associated with the expansion of insurance coverage. Our findings affirm the importance of insurance coverage in safeguarding low-income individuals from the adverse health consequences linked to infectious diseases.

Citing Articles

Does younger children's social health insurance alleviate household impoverishment due to illness?.

Zhou J, Zhan Y, Chen H, Chen S BMC Health Serv Res. 2024; 24(1):1152.

PMID: 39350239 PMC: 11443747. DOI: 10.1186/s12913-024-11558-z.

References

Sosa-Rubi S, Galarraga O, Lopez-Ridaura R . Diabetes treatment and control: the effect of public health insurance for the poor in Mexico. Bull World Health Organ. 2009; 87(7):512-9. PMC: 2704037. DOI: 10.2471/blt.08.053256. View

Card D, Dobkin C, Maestas N . DOES MEDICARE SAVE LIVES?. Q J Econ. 2009; 124(2):597-636. PMC: 2777733. DOI: 10.1162/qjec.2009.124.2.597. View

Trujillo A, Portillo J, Vernon J . The impact of subsidized health insurance for the poor: evaluating the Colombian experience using propensity score matching. Int J Health Care Finance Econ. 2005; 5(3):211-39. DOI: 10.1007/s10754-005-1792-5. View

Sommers B, Baicker K, Epstein A . Mortality and access to care among adults after state Medicaid expansions. N Engl J Med. 2012; 367(11):1025-34. DOI: 10.1056/NEJMsa1202099. View

Karan A, Yip W, Mahal A . Extending health insurance to the poor in India: An impact evaluation of Rashtriya Swasthya Bima Yojana on out of pocket spending for healthcare. Soc Sci Med. 2017; 181:83-92. PMC: 5408909. DOI: 10.1016/j.socscimed.2017.03.053. View

Miller G, Pinto D, Vera-Hernandez M . Risk Protection, Service Use, and Health Outcomes under Colombia's Health Insurance Program for the Poor. Am Econ J Appl Econ. 2014; 5(4):61-91. PMC: 4208673. DOI: 10.1257/app.5.4.61. View

Axelson H, Bales S, Minh P, Ekman B, Gerdtham U . Health financing for the poor produces promising short-term effects on utilization and out-of-pocket expenditure: evidence from Vietnam. Int J Equity Health. 2009; 8:20. PMC: 2694203. DOI: 10.1186/1475-9276-8-20. View

Yi H, Zhang L, Singer K, Rozelle S, Atlas S . Health insurance and catastrophic illness: a report on the New Cooperative Medical System in rural China. Health Econ. 2009; 18 Suppl 2:S119-27. DOI: 10.1002/hec.1510. View

Khatana S, Bhatla A, Nathan A, Giri J, Shen C, Kazi D . Association of Medicaid Expansion With Cardiovascular Mortality. JAMA Cardiol. 2019; 4(7):671-679. PMC: 6552110. DOI: 10.1001/jamacardio.2019.1651. View

10.

Babiarz K, Miller G, Yi H, Zhang L, Rozelle S . China's new cooperative medical scheme improved finances of township health centers but not the number of patients served. Health Aff (Millwood). 2012; 31(5):1065-74. DOI: 10.1377/hlthaff.2010.1311. View

11.

Liu Y . Development of the rural health insurance system in China. Health Policy Plan. 2004; 19(3):159-65. DOI: 10.1093/heapol/czh019. View

12.

You X, Kobayashi Y . The new cooperative medical scheme in China. Health Policy. 2009; 91(1):1-9. DOI: 10.1016/j.healthpol.2008.11.012. View

13.

Wagstaff A, Lindelow M . Can insurance increase financial risk? The curious case of health insurance in China. J Health Econ. 2008; 27(4):990-1005. DOI: 10.1016/j.jhealeco.2008.02.002. View

14.

King G, Gakidou E, Imai K, Lakin J, Moore R, Nall C . Public policy for the poor? A randomised assessment of the Mexican universal health insurance programme. Lancet. 2009; 373(9673):1447-54. DOI: 10.1016/S0140-6736(09)60239-7. View

15.

Thornton R, Hatt L, Field E, Islam M, Diaz F, Gonzalez M . Social security health insurance for the informal sector in Nicaragua: a randomized evaluation. Health Econ. 2010; 19 Suppl:181-206. DOI: 10.1002/hec.1635. View

16.

Finkelstein A, Taubman S, Wright B, Bernstein M, Gruber J, Newhouse J . THE OREGON HEALTH INSURANCE EXPERIMENT: EVIDENCE FROM THE FIRST YEAR. Q J Econ. 2013; 127(3):1057-1106. PMC: 3535298. DOI: 10.1093/qje/qjs020. View

17.

Bailey M, Goodman-Bacon A . The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans. Am Econ Rev. 2015; 105(3):1067-1104. PMC: 4436657. DOI: 10.1257/aer.20120070. View

18.

Kolstad J, Kowalski A . The Impact of Health Care Reform on Hospital and Preventive Care: Evidence from Massachusetts(☆). J Public Econ. 2012; 96(11-12):909-929. PMC: 3501746. DOI: 10.1016/j.jpubeco.2012.07.003. View

19.

Vilcu I, Probst L, Dorjsuren B, Mathauer I . Subsidized health insurance coverage of people in the informal sector and vulnerable population groups: trends in institutional design in Asia. Int J Equity Health. 2016; 15(1):165. PMC: 5050723. DOI: 10.1186/s12939-016-0436-3. View

20.

Swaminathan S, Sommers B, Thorsness R, Mehrotra R, Lee Y, Trivedi A . Association of Medicaid Expansion With 1-Year Mortality Among Patients With End-Stage Renal Disease. JAMA. 2018; 320(21):2242-2250. PMC: 6417808. DOI: 10.1001/jama.2018.16504. View