Jiang Yawen, Ni Weiyi
School of Public Health (Shenzhen), Sun Yat-sen University, Room 215, Mingde Garden #6, 132 East Outer Ring Road, Pan-yu District, Guangzhou, Guangdong, China.
Department of Pharmaceutical and Health Economics, University of Southern California, USC Schaeffer Center, 635 Downey Way, Verna & Peter Dauterive Hall (VPD) Suite 210, Los Angeles, CA 90089-3333, USA.
China Econ Rev. 2020 Oct;63:101514. doi: 10.1016/j.chieco.2020.101514. Epub 2020 Jul 3.
Private health insurance (PHI) is considered an important supplement to the basic social health insurance schemes in the Chinese healthcare system. However, whether the strategy of engaging PHI as supplementary coverage is effective cannot be determined without knowing the impact of supplementary PHI on healthcare access and utilization, the evidence on which is currently absent in China. Therefore, we aimed to investigate the effects of supplementary PHI on hospitalization and physical examination to provide such evidence in the Chinese setting. We conducted a cross-sectional analysis using data from the 2015 wave of China Health and Retirement Longitudinal Study (CHARLS). Using probit models and bivariate probit models with instrumental variables (IVs), we evaluated the effects of supplementary PHI on the utilization of hospitalization and physical examination. Our analyses provided evidence that supplementary PHI increased the probability of physical examination but decreased that of hospitalization. Our findings suggest that supplementary PHI in China may effectively promote the use of high-value preventive care, thereby reducing subsequent utilization of expensive medical services. The present study provided preliminary evidence that the China healthcare system can benefit from engaging PHI as supplements to SHI.
商业健康保险(PHI)被视为中国医疗体系中基本社会医疗保险计划的重要补充。然而,在不了解补充性商业健康保险对医疗服务可及性和利用情况影响的前提下,无法确定将其作为补充保险的策略是否有效,而目前中国尚缺乏这方面的证据。因此,我们旨在研究补充性商业健康保险对住院和体检的影响,以便在中国背景下提供此类证据。我们利用中国健康与养老追踪调查(CHARLS)2015年的数据进行了横断面分析。使用Probit模型和带有工具变量(IVs)的双变量Probit模型,我们评估了补充性商业健康保险对住院和体检利用情况的影响。我们的分析表明,补充性商业健康保险提高了体检概率,但降低了住院概率。我们的研究结果表明,中国的补充性商业健康保险可能有效地促进了高价值预防保健服务的使用,从而减少了后续对昂贵医疗服务的利用。本研究提供了初步证据,表明中国医疗体系可通过将商业健康保险作为社会医疗保险的补充而受益。