School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China.
School of Public Administration, Inner Mongolia University, Hohhot, China.
Front Public Health. 2022 Jul 22;10:889377. doi: 10.3389/fpubh.2022.889377. eCollection 2022.
This population-based study aims to explore the effect of the integration of the Urban and Rural Residents' Basic Medical Insurance (URRBMI) policy on the health outcomes of the middle-aged and elderly. A total of 13,360 participants in 2011 and 15,082 participants in 2018 were drawn from the China Health and Retirement Longitudinal Study. Health outcomes were evaluated using the prevalence of chronic diseases. A generalized linear mixed model was used to analyze the effect of the URRBMI policy on the prevalence of chronic disease. Prior to the introduction of the URRBMI policy, 67.09% of the rural participants and 73.00% of the urban participants had chronic diseases; after the policy's implementation, 43.66% of the rural participants and 45.48% of the urban participants had chronic diseases. When adjusting for the confounding factors, the generalized linear mixed model showed that the risk of having a chronic disease decreased by 81% [odds ratio (OR) = 0.19; 95% confidence interval (CI): 0.16, 0.23] after the introduction of the policy in the urban participants; in the rural participants, the risk of having a chronic disease was 30% lower (OR = 0.70; 95% CI: 0.60, 0.82) than the risk in the urban participants before the policy and 84% lower (OR = 0.16; 95% CI: 0.14, 0.19) after the implementation of the policy; the differences in the ORs decreased from 0.30 prior to the policy to 0.03 after the policy had been introduced between rural and urban participants when adjusting for the influence of socioeconomic factors on chronic diseases. This study provides evidence of the positive effects of the URRBMI policy on improving the rural population's health outcomes and reducing the gap in health outcomes between rural and urban populations, indicating that the implementation of the URRBMI policy has promoted the coverage of universal health.
本研究旨在探讨城乡居民基本医疗保险（URRBMI）政策整合对中老年人群健康结果的影响。从中国健康与养老追踪调查中抽取了 2011 年的 13360 名参与者和 2018 年的 15082 名参与者。使用慢性病患病率评估健康结果。采用广义线性混合模型分析 URRBMI 政策对慢性病患病率的影响。在实施 URRBMI 政策之前，农村参与者中有 67.09%和城市参与者中有 73.00%患有慢性病；政策实施后，农村参与者中有 43.66%和城市参与者中有 45.48%患有慢性病。在调整混杂因素后，广义线性混合模型显示，政策实施后，城市参与者慢性病的发病风险降低了 81%（比值比 [OR] = 0.19；95%置信区间 [CI]：0.16，0.23）；农村参与者慢性病的发病风险比城市参与者低 30%（OR = 0.70；95% CI：0.60，0.82），比政策实施前农村参与者低 84%（OR = 0.16；95% CI：0.14，0.19）；政策实施前后，农村和城市参与者之间的 OR 差异从政策实施前的 0.30 缩小到政策实施后的 0.03，说明在调整慢性病社会经济因素影响后，农村和城市参与者之间的差距有所缩小。本研究为 URRBMI 政策改善农村人口健康结果和缩小城乡人口健康结果差距的积极影响提供了证据，表明实施 URRBMI 政策促进了全民健康覆盖。
