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Health Insurance and Health Care among the Mid‐Aged and Older Chinese: Evidence from the National Baseline Survey of CHARLS

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  • Chuanchuan Zhang
  • Xiaoyan Lei
  • John Strauss
  • Yaohui Zhao

Abstract

We document the recent profile of health insurance and health care among mid‐aged and older Chinese using data from the China Health and Retirement Longitudinal Study conducted in 2011. Overall health insurance coverage is about 93%. Multivariate regressions show that respondents with lower income as measured by per capita expenditure have a lower chance of being insured, as do the less‐educated, older, and divorced/widowed women and rural‐registered people. Premiums and reimbursement rates of health insurance vary significantly by schemes. Inpatient reimbursement rates for urban people increase with total cost to a plateau of 60%; rural people receive much less. Demographic characteristics such as age, education, marriage status, per capita expenditure, and self‐reported health status are not significantly associated with share of out‐of‐pocket cost after controlling community effects. For health service use, we find large gaps that vary across health insurance plans, especially for inpatient service. People with access to urban health insurance plans are more likely to use health services. In general, Chinese people have easy access to median low‐level medical facilities. It is also not difficult to access general hospitals or specialized hospitals, but there exists better access to healthcare facilities in urban areas. Copyright © 2016 John Wiley & Sons, Ltd.

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  • Chuanchuan Zhang & Xiaoyan Lei & John Strauss & Yaohui Zhao, 2017. "Health Insurance and Health Care among the Mid‐Aged and Older Chinese: Evidence from the National Baseline Survey of CHARLS," Health Economics, John Wiley & Sons, Ltd., vol. 26(4), pages 431-449, April.
  • Handle: RePEc:wly:hlthec:v:26:y:2017:i:4:p:431-449
    DOI: 10.1002/hec.3322
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    References listed on IDEAS

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    2. Chan, Marc K. & Zeng, Guohua, 2018. "Unintended consequences of supply-side cost control? Evidence from China's new cooperative medical scheme," Journal of Health Economics, Elsevier, vol. 61(C), pages 27-46.
    3. Rui Wang & Chenjin Ma & Kun Jiang & Ming Li & Shuangge Ma, 2018. "Descriptions of self-treatment for the middle-aged and elderly in Shanxi, China," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-14, June.
    4. Hui Zhang & Wenjing Zhou & Donglan Zhang, 2022. "Direct Medical Costs of Parkinson’s Disease in Southern China: A Cross-Sectional Study Based on Health Insurance Claims Data in Guangzhou City," IJERPH, MDPI, vol. 19(6), pages 1-19, March.
    5. Wanyue Dong & Jianmin Gao & Zhongliang Zhou & Ruhai Bai & Yue Wu & Min Su & Chi Shen & Xin Lan & Xiao Wang, 2018. "Effects of China’s urban basic health insurance on preventive care service utilization and health behaviors: Evidence from the China Health and Nutrition Survey," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-14, December.
    6. Xiaotong Wen & Lanyue Cui & Fang Yuan & Xiaojun Liu & Mufeng Ouyang & Yuxiao Sun & Yuchen Liu & Yong Liu & Huiqiang Yu & Huilie Zheng & Yuanan Lu & Zhaokang Yuan, 2020. "Study on the Utilization of Inpatient Services for Middle-Aged and Elderly Rural Females in Less Developed Regions of China," IJERPH, MDPI, vol. 17(2), pages 1-18, January.
    7. Jiang, Yawen & Ni, Weiyi, 2020. "Impact of supplementary private health insurance on hospitalization and physical examination in China," China Economic Review, Elsevier, vol. 63(C).
    8. Yumei Zhu & August Österle, 2019. "China's policy experimentation on long‐term care insurance: Implications for access," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(4), pages 1661-1674, October.
    9. Yawen Jiang & Weiyi Ni, 2019. "Risk selection into supplemental private health insurance in China," Health Economics Review, Springer, vol. 9(1), pages 1-11, December.
    10. Sisi Yang & Katja Hanewald, 2022. "Life Satisfaction of Middle-Aged and Older Chinese: The Role of Health and Health Insurance," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 160(2), pages 601-624, April.
    11. Huang, Xian & Wu, Bingxiao, 2020. "Impact of urban-rural health insurance integration on health care: Evidence from rural China," China Economic Review, Elsevier, vol. 64(C).
    12. Zhao, Chunkai & Li, Xing, 2022. "Living under the shadow: Adverse childhood experiences and entrepreneurial behaviors in Chinese adults," Journal of Business Research, Elsevier, vol. 138(C), pages 239-255.
    13. Yanbing Zeng & Yuanyuan Wan & Zhipeng Yuan & Ya Fang, 2021. "Healthcare-Seeking Behavior among Chinese Older Adults: Patterns and Predictive Factors," IJERPH, MDPI, vol. 18(6), pages 1-18, March.
    14. Yinzi Jin & Zhiyuan Hou & Donglan Zhang, 2016. "Determinants of Health Insurance Coverage among People Aged 45 and over in China: Who Buys Public, Private and Multiple Insurance," PLOS ONE, Public Library of Science, vol. 11(8), pages 1-15, August.
    15. Feiyan Yang & Li Wei, 2023. "The impact of tax-subsidized health insurance on health and out-of-pocket burden in China," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 48(1), pages 194-246, January.

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