Risk Management and Healthcare Policy (Oct 2020)
Out-Patient Service and in-Patient Service: The Impact of Health Insurance on the Healthcare Utilization of Mid-Aged and Older Residents in Urban China
Abstract
Junqiang Han,1 Xiaodong Zhang,2 Yingying Meng2 1School of Public Management, South-Central University for Nationalities, Wuhan 430074, People’s Republic of China; 2Centre for Social Security Studies, Wuhan University, Wuhan 430072, People’s Republic of ChinaCorrespondence: Xiaodong Zhang; Yingying MengCentre for Social Security Studies, Wuhan University, Wuhan 430072, People’s Republic of ChinaEmail [email protected]; [email protected]: Medical insurance is a disease risk-sharing mechanism that can improve residents’ financial access to medical treatment and thus increase their utilization of health services. This paper aims to identify the impact of different kinds of medical insurances on the use of healthcare for Chinese mid-aged and older urban residents from four aspects: outpatient behaviour, outpatient costs, inpatient behaviour and inpatient costs.Materials and Methods: The data used in this study were from 2015 China Health and Retirement Longitudinal Study (CHARLS) conducted by Peking University. Binary logit model and multiple linear regression model were used to analyse the impact of health insurance on the use of healthcare, and the PSM method was used to test the robustness of the results.Results: Participating in either BMIUSE or BMISURR can significantly improve all kinds of healthcare utilization for mid-aged and older urban groups. However, there are huge differences on the healthcare utilization between BMISUE and BMISURR. Specifically, the probability of using inpatient care and inpatient costs of urban residents enrolled in the BMISUE are 4.2% and 45% higher, respectively, than those covered by the BMISURR, but there are no differences in outpatient care utilization and outpatient costs between these two health insurance programs.Conclusion: This paper suggests that the large gaps between BMISUE and BMISURR only reflect on inpatient care and inpatient costs, there is no difference in outpatient services between these two health insurance programs. “Excessive demand”, “induced demand” and other moral hazard phenomena in BMISUE should be avoided when receiving hospitalization services.Keywords: health insurance, out-patient service, in-patient service, mid-aged and older urban residents, CHARLS
