Health Research Policy and Systems (Nov 2022)

Degree of protection provided by poverty alleviation policies for the middle-aged and older in China: evaluation of effectiveness of medical insurance system tools and vulnerable target recognition

  • Wanxin Tian,
  • Bing Wu,
  • Yahong Yang,
  • Yongqiang Lai,
  • Wenqing Miao,
  • Xiyu Zhang,
  • Chenxi Zhang,
  • Qi Xia,
  • Linghan Shan,
  • Huiying Yang,
  • Huiqi Yang,
  • Zhipeng Huang,
  • Yuze Li,
  • Yiyun Zhang,
  • Fan Ding,
  • Yulu Tian,
  • Hongyu Li,
  • Xinwei Liu,
  • Ye Li,
  • Qunhong Wu

DOI
https://doi.org/10.1186/s12961-022-00929-9
Journal volume & issue
Vol. 20, no. 1
pp. 1 – 15

Abstract

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Abstract Background China’s medical insurance schemes and poverty alleviation policy at this stage have achieved population-wide coverage and the system's universal function. At the late stage of the elimination of absolute poverty task, how to further exert the poverty alleviation function of the medical insurance schemes has become an important agenda for targeted poverty alleviation. To analyse the risk of catastrophic health expenditure (CHE) occurrence in middle-aged and older adults with vulnerability characteristics from the perspectives of social, regional, disease, health service utilization and medical insurance schemes. Methods We used data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) database and came up with 9190 samples. The method for calculating the CHE was adopted from WHO. Logistic regression was used to determine the different characteristics of middle-aged and older adults with a high probability of incurring CHE. Results The overall regional poverty rate and incidence of CHE were similar in the east, central and west, but with significant differences among provinces. The population insured by the urban and rural integrated medical insurance (URRMI) had the highest incidence of CHE (21.17%) and health expenditure burden (22.77%) among the insured population. Integration of Medicare as a medical insurance scheme with broader benefit coverage did not have a significant effect on the incidence of CHE in middle-aged and older people with vulnerability characteristics. Conclusions Based on the perspective of Medicare improvement, we conducted an in-depth exploration of the synergistic effect of medical insurance and the poverty alleviation system in reducing poverty, and we hope that through comprehensive strategic adjustments and multidimensional system cooperation, we can lift the vulnerable middle-aged and older adults out of poverty.

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