Health Insurance and Health Care among the Mid-Aged and Older Chinese: Evidence from the National Baseline Survey of CHARLS

被引:78
|
作者
Zhang, Chuanchuan [1 ]
Lei, Xiaoyan [2 ]
Strauss, John [3 ]
Zhao, Yaohui [2 ]
机构
[1] Cent Univ Finance & Econ, Sch Econ, Beijing, Peoples R China
[2] Peking Univ, Natl Sch Dev, Beijing, Peoples R China
[3] Univ So Calif, Dept Econ, 318A Kaprielian Hall, Los Angeles, CA 90089 USA
基金
中国国家自然科学基金;
关键词
health insurance; health care; CHARLS; COOPERATIVE MEDICAL SCHEME; SYSTEM REFORM; SERVICES UTILIZATION; UNIVERSAL COVERAGE; RURAL CHINA; URBAN; PERFORMANCE; CHALLENGES; EQUITY; ACCESS;
D O I
10.1002/hec.3322
中图分类号
F [经济];
学科分类号
02 ;
摘要
We document the recent profile of health insurance and health care among mid-aged and older Chinese using data from the China Health and Retirement Longitudinal Study conducted in 2011. Overall health insurance coverage is about 93%. Multivariate regressions show that respondents with lower income as measured by per capita expenditure have a lower chance of being insured, as do the less-educated, older, and divorced/widowed women and rural-registered people. Premiums and reimbursement rates of health insurance vary significantly by schemes. Inpatient reimbursement rates for urban people increase with total cost to a plateau of 60%; rural people receive much less. Demographic characteristics such as age, education, marriage status, per capita expenditure, and self-reported health status are not significantly associated with share of out-of-pocket cost after controlling community effects. For health service use, we find large gaps that vary across health insurance plans, especially for inpatient service. People with access to urban health insurance plans are more likely to use health services. In general, Chinese people have easy access to median low-level medical facilities. It is also not difficult to access general hospitals or specialized hospitals, but there exists better access to healthcare facilities in urban areas. Copyright (c) 2016 John Wiley & Sons, Ltd.
引用
收藏
页码:431 / 449
页数:19
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