Yangling Ren1, Zhongliang Zhou2, Dan Cao3, Bernice Hua Ma4, Chi Shen5, Sha Lai5, Gang Chen6. 1. School of Public Administration, Southwestern University of Finance and Economics, Chengdu, China. Electronic address: ryling0317@163.com. 2. School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China. Electronic address: zzliang1981@163.com. 3. School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China. Electronic address: cdan1996@163.com. 4. Centre for Health Economics, Monash University, Melbourne, Australia. Electronic address: hua.ma@monash.edu. 5. School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China. 6. Centre for Health Economics, Monash University, Melbourne, Australia.
Abstract
OBJECTIVES: The reform of merging 2 major health insurance schemes into Urban and Rural Resident Basic Medical Insurance (URRBMI) is recognized as a vital step to safeguard equal healthcare and benefit to each enrollee in China. Against this backdrop, this article aims to evaluate the impact of URRBMI integration on benefit and its contribution to benefit equity. METHODS: The data of this study were derived from the China Health and Retirement Longitudinal Study 2011 and 2015. A total of 11 383 individuals were included in the final sample. Coarsened exact matching with difference-in-difference approach was firstly adopted to investigate the treatment effects of URRBMI on benefits. Next, the decomposition of concentration index (CI) was conducted to explore the contribution of URRBMI to benefit equity. RESULTS: The coarsened exact matching with difference-in-difference results revealed that the consolidation of URRBMI has significantly improved outpatient benefit. The decomposition results showed that the contribution rates of URRBMI scheme to outpatient benefit rate (CI -0.0114), benefit probability (CI 0.0673), compensation fee (CI 0.0076), and reimbursement ratio (CI 0.0483) were 11.26%, -3.38%, -7.67%, and -0.81%, suggesting that this reform makes contribution to the propoor inequity in the outpatient benefit rate and relieves the prorich inequity in outpatient benefit probability and the degree of benefits. CONCLUSIONS: The findings of this study provide novel evidence of enhanced benefits and benefit equity for outpatient care with the integration of URRBMI. Further efforts should be made to the expansion of URRBMI coverage and the elimination of income disparities that affecting benefit equity.
OBJECTIVES: The reform of merging 2 major health insurance schemes into Urban and Rural Resident Basic Medical Insurance (URRBMI) is recognized as a vital step to safeguard equal healthcare and benefit to each enrollee in China. Against this backdrop, this article aims to evaluate the impact of URRBMI integration on benefit and its contribution to benefit equity. METHODS: The data of this study were derived from the China Health and Retirement Longitudinal Study 2011 and 2015. A total of 11 383 individuals were included in the final sample. Coarsened exact matching with difference-in-difference approach was firstly adopted to investigate the treatment effects of URRBMI on benefits. Next, the decomposition of concentration index (CI) was conducted to explore the contribution of URRBMI to benefit equity. RESULTS: The coarsened exact matching with difference-in-difference results revealed that the consolidation of URRBMI has significantly improved outpatient benefit. The decomposition results showed that the contribution rates of URRBMI scheme to outpatient benefit rate (CI -0.0114), benefit probability (CI 0.0673), compensation fee (CI 0.0076), and reimbursement ratio (CI 0.0483) were 11.26%, -3.38%, -7.67%, and -0.81%, suggesting that this reform makes contribution to the propoor inequity in the outpatient benefit rate and relieves the prorich inequity in outpatient benefit probability and the degree of benefits. CONCLUSIONS: The findings of this study provide novel evidence of enhanced benefits and benefit equity for outpatient care with the integration of URRBMI. Further efforts should be made to the expansion of URRBMI coverage and the elimination of income disparities that affecting benefit equity.
Authors: Caiyao Xu; Chen Qian; Wencai Yang; Bowei Li; Lingqian Kong; Fanbin Kong Journal: Int J Environ Res Public Health Date: 2022-07-09 Impact factor: 4.614