Unequal nursing: the impact of China’s public health insurance on nursing services for older adults

Abstract Background This study examines the relationship between public health insurance and inequality in nursing services for older adults and explores the different impacts of different public health insurance systems in China. Methods Using data from the China Health and Retirement Longitudinal...

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Main Authors: Pengfei Zhang, Jinghua Gao
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Nursing
Subjects:
Online Access:https://doi.org/10.1186/s12912-025-03459-1
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author Pengfei Zhang
Jinghua Gao
author_facet Pengfei Zhang
Jinghua Gao
author_sort Pengfei Zhang
collection DOAJ
description Abstract Background This study examines the relationship between public health insurance and inequality in nursing services for older adults and explores the different impacts of different public health insurance systems in China. Methods Using data from the China Health and Retirement Longitudinal Study, a logistic regression model was used to examine the use of nursing services by people aged 60 years and above. Results The results show that participation in public health insurance can significantly improve the chances of older adults accessing nursing services, with participants being 53.57% more likely than nonparticipants to use nursing services. In addition, older adults enrolled in the Urban Employee Basic Medical Insurance program were 26.49% more likely than those enrolled in the Urban‒Rural Resident Basic Medical Insurance program to utilize nursing services, underscoring the substantial inequalities resulting from the structural differences within the public health insurance system. Conclusions Although public health insurance plays a key role in improving the accessibility of nursing services for older adults, it also exacerbates existing inequalities. China’s health security reform should improve access to nursing services by increasing participation in public health insurance and eliminating discrimination based on status within the insurance framework.
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spelling doaj-art-5a1f7af791ca42b8aab4bbf06e8e65762025-08-20T03:37:20ZengBMCBMC Nursing1472-69552025-07-0124111110.1186/s12912-025-03459-1Unequal nursing: the impact of China’s public health insurance on nursing services for older adultsPengfei Zhang0Jinghua Gao1School of Management, Minzu University of ChinaCollege of Humanities and Development Studies, China Agricultural UniversityAbstract Background This study examines the relationship between public health insurance and inequality in nursing services for older adults and explores the different impacts of different public health insurance systems in China. Methods Using data from the China Health and Retirement Longitudinal Study, a logistic regression model was used to examine the use of nursing services by people aged 60 years and above. Results The results show that participation in public health insurance can significantly improve the chances of older adults accessing nursing services, with participants being 53.57% more likely than nonparticipants to use nursing services. In addition, older adults enrolled in the Urban Employee Basic Medical Insurance program were 26.49% more likely than those enrolled in the Urban‒Rural Resident Basic Medical Insurance program to utilize nursing services, underscoring the substantial inequalities resulting from the structural differences within the public health insurance system. Conclusions Although public health insurance plays a key role in improving the accessibility of nursing services for older adults, it also exacerbates existing inequalities. China’s health security reform should improve access to nursing services by increasing participation in public health insurance and eliminating discrimination based on status within the insurance framework.https://doi.org/10.1186/s12912-025-03459-1Nursing servicesInequalityPublic health insuranceOlder adults
spellingShingle Pengfei Zhang
Jinghua Gao
Unequal nursing: the impact of China’s public health insurance on nursing services for older adults
BMC Nursing
Nursing services
Inequality
Public health insurance
Older adults
title Unequal nursing: the impact of China’s public health insurance on nursing services for older adults
title_full Unequal nursing: the impact of China’s public health insurance on nursing services for older adults
title_fullStr Unequal nursing: the impact of China’s public health insurance on nursing services for older adults
title_full_unstemmed Unequal nursing: the impact of China’s public health insurance on nursing services for older adults
title_short Unequal nursing: the impact of China’s public health insurance on nursing services for older adults
title_sort unequal nursing the impact of china s public health insurance on nursing services for older adults
topic Nursing services
Inequality
Public health insurance
Older adults
url https://doi.org/10.1186/s12912-025-03459-1
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AT jinghuagao unequalnursingtheimpactofchinaspublichealthinsuranceonnursingservicesforolderadults