The impact of urbanization and economic development on health insurance performance: Evidence from China

Jianfeng Yao, Agir Kurmaj

Article ID: 3910
Vol 8, Issue 5, 2024

VIEWS - 55 (Abstract) 18 (PDF)

Abstract


Many previous studies find no significant effect of health insurance on health outcome in rural areas of China. Many researchers believe this could be because of the characteristics of health care provision in those areas. In this paper, we aim to examine if urbanization will change the situation. Our research question focuses on if urbanization will change the participation and performance of health insurance on health outcome in a positive direction. Using a longitudinal sample drawn from the China Health and Nutrition Survey (CHNS), we employed multiple estimation strategies for multiple waves to handle the potential selection bias. We find that urbanization factors such as population density, transportations and housing are associated with probability of insurance participation. That is, urbanization related factors tend to increase people’s willingness of insurance participation. We also conclude that urbanization improves the performance of insurance on self-reported health outcome. Results show that the health insurance has a significant positive impact on health production in urbanized areas. Health insurance in general increases the probability of health care utilization for all areas. However, it does not lead to a significant improvement in the health outcomes in under urbanized areas because of the health provision quality or characteristics of health insurance coverage in those areas.


Keywords


urbanization; economic development; health insurance; health care utilization; health economics

Full Text:

PDF


References


Cheng, L., Liu, H., Zhang, Y., et al. (2014). The Impact of Health Insurance on Health Outcomes and Spending of the Elderly: Evidence from China’s New Cooperative Medical Scheme. Health Economics, 24(6), 672–691. https://doi.org/10.1002/hec.3053

Chu, X. L. (2010). Health Human Capital of Rural Residents: Income Effects and Impact Factors (Chinese) [Dissertation]. Hangzhou: Zhejiang University, China.

Feng, L. Financing behavior of farm households under the risk of major illness in poverty-stricken area (Chinese) [Dissertation]. Wuhan: Huazhong Agricultural University, China. 2009.

Heckman J. J. (2009). A Note on Adapting Propensity Score Matching and Selection Models to Choice Based Samples. Econom J., 12(1), 230-234. https://doi.org/10.1111/j.1368-423X.2008.00269.x

Heckman, J. J. (1999). Instrumental Variables: Response to Angrist and Imbens. Journal of Human Resources, University of Wisconsin Press, 34(4), 828–837.

Lei, X., & Lin, W. (2009). The New Cooperative Medical Scheme in rural China: Does more coverage mean more service and better health? Health Economics, 18(S2). https://doi.org/10.1002/hec.1501

Li, X. Y., Xie, C. Q., Yang, M. H. (2008). A Study on the Equity of Rural New Cooperative Medical Care System—Based on the Pilot in Heilongjiang Province (Chinese). Journal of South China Agricultural University (Social Science Edition), 7, 9–15.

Liang, X., Guo, H., Jin, C., et al. (2012). The Effect of New Cooperative Medical Scheme on Health Outcomes and Alleviating Catastrophic Health Expenditure in China: A Systematic Review. PloS One, 7(8), 1-11.

Lipow, C. (2010). The impact of the New Cooperative Medical Scheme in rural China: Do those who live far from a medical facility benefit more from NCMS participation [M.P.P]. District of Columbia: Georgetown University. 2010.

Ma, X., Cen, Y. (2017). Health Insurance System Reform and Its Impact on Health Service Utilization in Rural China: Evidence from CHNS 2000 and 2011.

Meng, D. F., Zhang, B., Wang, Y. Q. (2009). Empirical study on effects of New Cooperative Medical Schemes on health service utilization—Case of Jiangsu Province. Jing Ji Ping Lun, 69–76.

Miao, Y. H., Zhang, S. (2008). Effect of New Rural Cooperative Medical Scheme: A Supply-demand Perspective. Issues in Agricultural Economy, 30, 71–78.

Qiu, R. (2012). Chapitre 1. Healthcare sector reform and its influence on public hospitals in mainland China. Journal International de Bioéthique, 23(2), 15. https://doi.org/10.3917/jib.232.0015

Shen, Z. W., Jiang, Y. S. (2008). Determinants of Health Status and Household Health Expenditure Among Western Rural Residents—Based on the Investigation in Sichuan and Shanxi provinces. Journal of Agrotechnical Economics, 3, 58–64.

Statistical Information Center MOH. (2007). Progress and Impact Evaluation of Chinese New Cooperative Medical Scheme. Beijing: Beijing Union Medical University Press.

Statistical Information Center, Ministry of Health, China. (2007). Progress and impact evaluation of Chinese New Cooperative Medical Scheme. Beijing: Beijing Union Medical University Press.

Sun, Y. (2005). Disease Economic Risk for the Rural Residents in Shanxi Pilot Counties of New Cooperative Medical Scheme (Chinese) [Thesis]. Taiyuan: Shanxi Medical University, China.

The Ministry of Health, China. (2012). The Notice of Preparation for the New Rural Cooperative Medical in Beijing, China: The Ministry of Health. Available online: https://www.gov.cn/zwgk/2012-05/25/content_2145389.htm (accessed on 25 June 2022).

Van de Poel, E., O’Donnell, O., Van Doorslaer, E. (2012). Is There a Health Penalty of China’s Rapid Urbanization? Health Econ, 21, 367-385.

Wagstaff, A., Lindelow, M., Gao, J., et al. (2007). Extending health insurance to the rural population: An impact evaluation of China’s New Cooperative Medical Scheme. World Bank Policy Research Working Paper 4150.

Wu, L. C., Shen, S. G. (2010). The Effect of New Cooperative Medical Scheme on Health Outcome of the Rural Residents: An Empirical Study. Insurance Studies, 6, 60–68.

Yan, J. E., Fan, T. T., Shi, S. L. (2009). Evaluation of Effects of Disease Economic Risk Alleviation of New Cooperative Medical System. Modern Preventive Medicine, 36, 259-262.




DOI: https://doi.org/10.24294/jipd.v8i5.3910

Refbacks

  • There are currently no refbacks.


Copyright (c) 2024 Jianfeng Yao, Agir Kurmaj

License URL: https://creativecommons.org/licenses/by/4.0/

This site is licensed under a Creative Commons Attribution 4.0 International License.