The Mixed Effect of China’s New Health Care Reform on Health Insurance Coverage and the Efficiency of Health Service Utilisation: A Longitudinal Approach
In 2009, China launched a new health care reform as it endeavoured to develop a tiered system of disease diagnosis and treatment to promote the integration of medical resources. This was important for improving service capacity and building medical alliances that would eventually lead to improved he...
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doaj-12ad147cc4ea4fe28c5e6b4f8f4d4a402020-11-25T03:03:56ZengMDPI AGInternational Journal of Environmental Research and Public Health1660-46012020-03-01175178210.3390/ijerph17051782ijerph17051782The Mixed Effect of China’s New Health Care Reform on Health Insurance Coverage and the Efficiency of Health Service Utilisation: A Longitudinal ApproachJiaqi Chen0Song Xu1Jing Gao2School of Business, Jiangnan University, 1800 Lihu Ave, Binhu District, Wuxi 214122, ChinaSchool of Medicine, Jiangnan University, 1800 Lihu Ave, Binhu District, Wuxi 214122, ChinaSchool of Business, Jiangnan University, 1800 Lihu Ave, Binhu District, Wuxi 214122, ChinaIn 2009, China launched a new health care reform as it endeavoured to develop a tiered system of disease diagnosis and treatment to promote the integration of medical resources. This was important for improving service capacity and building medical alliances that would eventually lead to improved health service utilisation efficiency. However, while the 2009 reform aimed to provide universal health insurance coverage to all citizens, its overall effect on health service utilisation efficiency remains unclear. We aimed to examine the new health care reform’s mixed effect by applying a longitudinal study using China Health and Nutrition Survey (CHNS) data and the difference-in-difference (DID) method to estimate the health reform’s impact on health insurance coverage rate. Then, we studied whether the increase in health insurance coverage rate affected health service utilisation efficiency in China. Our results showed that the increase in insurance coverage rate has indeed made expensive medical services available to low-income individuals. However, it also increased the likelihood of use of hospitals rather than primary care facilities, since there is more insurance cover for outpatient visits, which has led to an increased demand for quality services. This effect has generated a negative impact on health care utilisation which directly pertains to systemic inefficiency. This study thus indicates that China’s latest health reform requires further policies to improve its overall efficiency.https://www.mdpi.com/1660-4601/17/5/1782health care reformhealth insurance coveragehealth service utilisationhealth resource allocation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jiaqi Chen Song Xu Jing Gao |
spellingShingle |
Jiaqi Chen Song Xu Jing Gao The Mixed Effect of China’s New Health Care Reform on Health Insurance Coverage and the Efficiency of Health Service Utilisation: A Longitudinal Approach International Journal of Environmental Research and Public Health health care reform health insurance coverage health service utilisation health resource allocation |
author_facet |
Jiaqi Chen Song Xu Jing Gao |
author_sort |
Jiaqi Chen |
title |
The Mixed Effect of China’s New Health Care Reform on Health Insurance Coverage and the Efficiency of Health Service Utilisation: A Longitudinal Approach |
title_short |
The Mixed Effect of China’s New Health Care Reform on Health Insurance Coverage and the Efficiency of Health Service Utilisation: A Longitudinal Approach |
title_full |
The Mixed Effect of China’s New Health Care Reform on Health Insurance Coverage and the Efficiency of Health Service Utilisation: A Longitudinal Approach |
title_fullStr |
The Mixed Effect of China’s New Health Care Reform on Health Insurance Coverage and the Efficiency of Health Service Utilisation: A Longitudinal Approach |
title_full_unstemmed |
The Mixed Effect of China’s New Health Care Reform on Health Insurance Coverage and the Efficiency of Health Service Utilisation: A Longitudinal Approach |
title_sort |
mixed effect of china’s new health care reform on health insurance coverage and the efficiency of health service utilisation: a longitudinal approach |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1660-4601 |
publishDate |
2020-03-01 |
description |
In 2009, China launched a new health care reform as it endeavoured to develop a tiered system of disease diagnosis and treatment to promote the integration of medical resources. This was important for improving service capacity and building medical alliances that would eventually lead to improved health service utilisation efficiency. However, while the 2009 reform aimed to provide universal health insurance coverage to all citizens, its overall effect on health service utilisation efficiency remains unclear. We aimed to examine the new health care reform’s mixed effect by applying a longitudinal study using China Health and Nutrition Survey (CHNS) data and the difference-in-difference (DID) method to estimate the health reform’s impact on health insurance coverage rate. Then, we studied whether the increase in health insurance coverage rate affected health service utilisation efficiency in China. Our results showed that the increase in insurance coverage rate has indeed made expensive medical services available to low-income individuals. However, it also increased the likelihood of use of hospitals rather than primary care facilities, since there is more insurance cover for outpatient visits, which has led to an increased demand for quality services. This effect has generated a negative impact on health care utilisation which directly pertains to systemic inefficiency. This study thus indicates that China’s latest health reform requires further policies to improve its overall efficiency. |
topic |
health care reform health insurance coverage health service utilisation health resource allocation |
url |
https://www.mdpi.com/1660-4601/17/5/1782 |
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