Department of Health Services, UCLA Fielding School of Public Health, University of California-Los Angeles, CA 90095, USA.
J Rural Health. 2013 Aug;29 Suppl 1:s51-61. doi: 10.1111/jrh.12013. Epub 2013 Mar 5.
With its population rapidly aging, China needs prompt action to facilitate the middle-aged and senior citizens' utilization of health care. The New Rural Cooperative Medical Scheme (NCMS), a health care reform initiative started in 2003, is currently China's primary insurance program for the rural population.
With a 2-province pilot sample (Gansu, the poorest province, and Zhejiang, one of the richest) of people over age 45 from the China Health and Retirement Longitudinal Study (CHARLS), this paper used logistic regressions to examine the association between the coverage of New Rural Cooperative Medical Scheme and the underutilization of medical care.
Among those who had a need to visit a health care provider during the previous month, people covered by NCMS were more likely to underutilize outpatient care than the uninsured (Odds Ratio = 5.610, 2.035-15.466). As for those who had a need to be hospitalized in the past year, the association between NCMS coverage and the underutilization of inpatient care was not statistically significant (Odds Ratio = 1.907, 0.335-10.862). Low total household expenditure per capita, living in the inland province of Gansu, and being an urban resident were also associated with underutilizing outpatient care.
Further research is needed to understand the negative association between NCMS coverage and outpatient care utilization.
随着中国人口迅速老龄化，需要迅速采取行动，方便中年和老年公民利用医疗保健。新农合是 2003 年启动的一项医疗改革举措，是中国农村人口的主要保险计划。
本研究利用中国健康与养老追踪调查（CHARLS）的两省试点（甘肃，最贫困的省份；浙江，最富裕的省份之一）中年龄在 45 岁以上的人群数据，采用逻辑回归分析新农合覆盖与医疗服务利用不足之间的关系。
在过去一个月有医疗需求的人群中，参加新农合的人群比未参保人群更有可能未充分利用门诊服务（优势比=5.610，2.035-15.466）。对于过去一年有住院需求的人群，新农合覆盖与住院服务利用不足之间的关联无统计学意义（优势比=1.907，0.335-10.862）。人均家庭总支出低、居住在甘肃省内陆省份以及城镇居民也与未充分利用门诊服务有关。
需要进一步研究以了解新农合覆盖与门诊服务利用不足之间的负相关关系。
