Health poverty reduction effect of medical insurance in China’s middle-aged and elderly populations: a cross-sectional study
Objectives In the context of demographic structure and disease spectrum changes: to study the role of the medical insurance system in providing protection and risk resilience for middle-aged and elderly vulnerable groups who are prone to impoverishment by medical expenses (IME), identify the vulnera...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2025-04-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/4/e085226.full |
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| author | Haijun Yang Rui Chen Ye Li Qunhong Wu Linghan Shan Bing Wu Fang Yin Yiyun Zhang Yongqiang Lai Xinwei Liu Wanxin Tian Xiyu Zhang Yujuan Xu Wenqing Miao Baoguo Shi Feifei Leng |
| author_facet | Haijun Yang Rui Chen Ye Li Qunhong Wu Linghan Shan Bing Wu Fang Yin Yiyun Zhang Yongqiang Lai Xinwei Liu Wanxin Tian Xiyu Zhang Yujuan Xu Wenqing Miao Baoguo Shi Feifei Leng |
| author_sort | Haijun Yang |
| collection | DOAJ |
| description | Objectives In the context of demographic structure and disease spectrum changes: to study the role of the medical insurance system in providing protection and risk resilience for middle-aged and elderly vulnerable groups who are prone to impoverishment by medical expenses (IME), identify the vulnerable points and propose recommendations for improving the medical insurance system.Setting The research used data from the 2018 China Health and Retirement Longitudinal Study.Participants 9184 households were included in the research ultimately.Primary and secondary outcome measures We use the WHO’s recommended composite measure of disease-related poverty and algorithm to determine the occurrence of IME in households. Instrumental variable probit regression model was used to target the characteristics of vulnerable groups and the influencing factors with strong correlation with IME.Results The overall incidence of IME is 8.25% and the high incidence is concentrated in rural populations (9.79%). The risk of IME from stroke (13.17%) has been higher than cancer (7.38%). The incidence of IME is higher in families with five types of non-communicable diseases enrolled in Urban-Rural Integrated Medical Insurance (URRMI) (min 10.00%–max 14.29%) and New Rural Cooperative Medical Insurance Scheme (NRCMS) (min 8.97%–max 15.24%) health insurance than the overall IME incidence (8.25%).Conclusions The medical insurance system has achieved the inclusive economic protection function for most people, but the risk resistance function for the middle-aged and older adults with multiple vulnerabilities still needs to be strengthened.,the.Finally, to address the benefit gap of the NRCMS, the next stage of medical insurance development should focus on improving the top-level design of the reimbursement framework for urban and rural resident medical insurance. |
| format | Article |
| id | doaj-art-55a108cbc0a840b696c6df724bd62d87 |
| institution | OA Journals |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-55a108cbc0a840b696c6df724bd62d872025-08-20T02:10:41ZengBMJ Publishing GroupBMJ Open2044-60552025-04-0115410.1136/bmjopen-2024-085226Health poverty reduction effect of medical insurance in China’s middle-aged and elderly populations: a cross-sectional studyHaijun Yang0Rui Chen1Ye Li2Qunhong Wu3Linghan Shan4Bing Wu5Fang Yin6Yiyun Zhang7Yongqiang Lai8Xinwei Liu9Wanxin Tian10Xiyu Zhang11Yujuan Xu12Wenqing Miao13Baoguo Shi14Feifei Leng15Yan’an Hospital of Kunming City, Kunming, Yunnan, ChinaDepartment of Breast Disease, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, ChinaSchool of Public Administration, Hangzhou Normal University, Hangzhou, Zhejiang, ChinaDepartment of Social Medicine, School of Health Management, Harbin Medical University, Harbin, ChinaDepartment of Social Medicine,School of Health Management, Harbin Medical University, Harbin, Heilongjiang, ChinaResearch Center of Public Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, ChinaTenth People’s Hospital of Shanghai, ChinaSchool of Ethnology and Sociology, Yunnan University, Kunming, Yunnan, ChinaResearch Center of Public Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, ChinaResearch Center of Public Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, ChinaNational Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, ChinaResearch Center of Public Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, ChinaThe First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, ChinaDepartment of Science and Technology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, ChinaDepartment of Economics, School of Economics, Minzu University of China, Beijing, ChinaNursing Department, Heilongjiang Provincial Hospital, Harbin, Heilongjiang, ChinaObjectives In the context of demographic structure and disease spectrum changes: to study the role of the medical insurance system in providing protection and risk resilience for middle-aged and elderly vulnerable groups who are prone to impoverishment by medical expenses (IME), identify the vulnerable points and propose recommendations for improving the medical insurance system.Setting The research used data from the 2018 China Health and Retirement Longitudinal Study.Participants 9184 households were included in the research ultimately.Primary and secondary outcome measures We use the WHO’s recommended composite measure of disease-related poverty and algorithm to determine the occurrence of IME in households. Instrumental variable probit regression model was used to target the characteristics of vulnerable groups and the influencing factors with strong correlation with IME.Results The overall incidence of IME is 8.25% and the high incidence is concentrated in rural populations (9.79%). The risk of IME from stroke (13.17%) has been higher than cancer (7.38%). The incidence of IME is higher in families with five types of non-communicable diseases enrolled in Urban-Rural Integrated Medical Insurance (URRMI) (min 10.00%–max 14.29%) and New Rural Cooperative Medical Insurance Scheme (NRCMS) (min 8.97%–max 15.24%) health insurance than the overall IME incidence (8.25%).Conclusions The medical insurance system has achieved the inclusive economic protection function for most people, but the risk resistance function for the middle-aged and older adults with multiple vulnerabilities still needs to be strengthened.,the.Finally, to address the benefit gap of the NRCMS, the next stage of medical insurance development should focus on improving the top-level design of the reimbursement framework for urban and rural resident medical insurance.https://bmjopen.bmj.com/content/15/4/e085226.full |
| spellingShingle | Haijun Yang Rui Chen Ye Li Qunhong Wu Linghan Shan Bing Wu Fang Yin Yiyun Zhang Yongqiang Lai Xinwei Liu Wanxin Tian Xiyu Zhang Yujuan Xu Wenqing Miao Baoguo Shi Feifei Leng Health poverty reduction effect of medical insurance in China’s middle-aged and elderly populations: a cross-sectional study BMJ Open |
| title | Health poverty reduction effect of medical insurance in China’s middle-aged and elderly populations: a cross-sectional study |
| title_full | Health poverty reduction effect of medical insurance in China’s middle-aged and elderly populations: a cross-sectional study |
| title_fullStr | Health poverty reduction effect of medical insurance in China’s middle-aged and elderly populations: a cross-sectional study |
| title_full_unstemmed | Health poverty reduction effect of medical insurance in China’s middle-aged and elderly populations: a cross-sectional study |
| title_short | Health poverty reduction effect of medical insurance in China’s middle-aged and elderly populations: a cross-sectional study |
| title_sort | health poverty reduction effect of medical insurance in china s middle aged and elderly populations a cross sectional study |
| url | https://bmjopen.bmj.com/content/15/4/e085226.full |
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