A Study on the Effects of the Integration Policy of Basic Medical Insurance for Urban and Rural Residents on the Health and Health Inequality of Middle and Elderly People
10.11783/j.issn.1002-3674.2025.03.001
- VernacularTitle:城乡居民基本医疗保险整合政策对中老年人健康及健康不平等的影响研究
- Author:
Liangwen ZHANG
1
;
Rui CHEN
;
Ying DUAN
Author Information
1. 厦门大学公共卫生学院(361102);福建省高校卫生技术评估重点实验室
- Publication Type:Journal Article
- Keywords:
Medical insurance;
Middle aged and elderly people;
Health;
Health inequality
- From:
Chinese Journal of Health Statistics
2025;42(3):322-327
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the impact of urban and rural resident basic medical insurance(URRBMI)integration policy on the health and health inequality of middle-aged and elderly people,and to provide an evidence-based basis for further improving the URRBMI system.Methods Based on data from the China health and retirement longitudinal study(CHARLS)from 2013 to 2018,the impact of the URRBMI integration policy on the self-rated health,disability,and depression of middle-aged and elderly people was investigated using the staggered differences-in-differences method.The health inequality status of middle-aged and elderly people and its change trend were analyzed by the concentration index,and the index was decomposed according to different years and different integration modes to explore the impact of URRBMI on health inequality of middle-aged and elderly people.Results A study was conducted on 7589 middle-aged and elderly individuals,which found that the URRBMI integration policy had a significant positive impact on the self-rated health of this population(OR=1.309,P<0.001).Additionally,the policy had a significant negative impact on the occurrence of depression(OR=0.696,P<0.001).However,it was found to increase the disability score of middle-aged and elderly individuals(β=0.354,P<0.001)and did not improve their disability status.In addition,health disparity exists among middle-aged and elderly people in China,and middle-aged and elderly people with health problems are mainly concentrated in groups with lower socioeconomic status,and health disparity has been increasing over time.Health insurance for urban and rural residents has a certain effect on alleviating health inequality,the contribution rate of disability inequality and depression inequality decreased from 1.21%and 1.20%in 2013 to-0.58%and 0.31%in 2018,respectively,and compared with the one-tier model,the split-tier system has a greater negative impact on the health status of low-income groups.Conclusion The URRBMI integration policy improved the self-rated health and depression status of middle-aged and elderly people,but had a limited effect on improving the disability status.The policy can reduce the health inequality of middle-aged and elderly people to some extent,but the health inequality varies widely within the population.It is recommended to strengthen the top-level design of URRBMI,to shift from a strategy that emphasizes medicine over prevention to one that emphasizes prevention and combines prevention and treatment,and to shift from formal equity based on the elimination of household boundaries to substantive equity based on the elimination of reimbursement policies and other barriers.
