Department of Information Management, Da-Yeh University, No.168, University Rd., Dacun, Changhua, 515006, Taiwan, R.O.C.
Johns Hopkins Primary Care Policy Center, Baltimore, MD, 21205, USA.
BMC Health Serv Res. 2022 Feb 3;22(1):140. doi: 10.1186/s12913-022-07498-1.
The study examined the relationship between health insurance coverage and access to needed healthcare including preventive, primary, and tertiary care among Chinese adult population.
Data for this study came from the 2018 China Health and Retirement Longitudinal Study (CHARLS), a population-based probability sample survey. Key measures included insurance coverage (high-, moderate-, low- and no-insurance), access to care (physical examination, physician visit, office visit, inpatient care, and satisfaction with care), and personal sociodemographics. Multiple-factor generalized linear mixed model was applied to estimate the odds ratio (OR) and the 95% confidence interval (CI) of HI coverage for the four indicators of access to care, after controlling for individual characteristics and aggregation among different villages.
The majority of Chinese adults had some health insurance with only 3.15% uninsured. However, most had low-coverage insurance (64.82%), followed by moderate-coverage insurance (16.70%), and high-coverage insurance (15.33%). Health insurance was significantly and positively associated with access to needed healthcare (preventive, primary, and tertiary). There was also a significant gradient association between extent of insurance coverage and access to care.
Not only health insurance mattered in enhancing access to care but that there was a significant gradient association between extent of insurance coverage and access to care with higher coverage relating to better access.
本研究考察了医疗保险覆盖范围与中国成年人群体获得所需医疗保健的关系，包括预防、初级和三级保健。
本研究的数据来自于 2018 年中国健康与退休纵向研究（CHARLS），这是一项基于人口的概率抽样调查。主要措施包括保险覆盖（高、中、低和无保险）、获得医疗保健（体检、医生就诊、门诊、住院治疗和对医疗保健的满意度）以及个人社会人口统计学特征。在控制个体特征和不同村庄之间的聚集效应后，采用多因素广义线性混合模型估计医疗保险覆盖对四个获得医疗保健指标的优势比（OR）和 95%置信区间（CI）。
大多数中国成年人都有某种医疗保险，只有 3.15%的人没有保险。然而，大多数人只有低覆盖的保险（64.82%），其次是中覆盖的保险（16.70%）和高覆盖的保险（15.33%）。医疗保险与获得所需医疗保健（预防、初级和三级）显著正相关。保险覆盖范围与获得医疗保健之间也存在显著的梯度关联。
医疗保险不仅对提高医疗保健的可及性很重要，而且保险覆盖范围与获得医疗保健之间存在显著的梯度关联，覆盖范围越高，获得的医疗保健越好。
