Liu Zhe, Wu Xingyuan, Chen Xi, Qin Congzhi, Qiu Zenghui, Fang Zhuangzhi, Yao Lan
School of Medicine and Health Management, Tongji, Medical College, Huazhong University of Science and Technology, Wuhan, China.
School of Economics, Huazhong University of Science and Technology, Wuhan, China.
Front Public Health. 2025 Apr 24;13:1586780. doi: 10.3389/fpubh.2025.1586780. eCollection 2025.
The influence of digital financial inclusion on medical insurance systems has drawn significant attention. However, its impact on China's multilevel medical insurance system (MMIS) remains uncertain. The MMIS is crucial for societal wellbeing. It safeguards citizens from financial hardships during medical treatment, especially as the population ages and healthcare costs rise. By covering medical expenses, the MMIS ensures equal access to essential medical services, protecting people's health rights and preventing impoverishment caused by medical expenses, thus promoting social stability and equity. This study used panel data from 31 provinces in China from 2016 to 2020 to explore the impact of digital financial inclusion on the development of the MMIS.
An MMIS development matrix was constructed using the entropy weight method and the Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS). Panel data regression models were employed to analyze the effects of different dimensions of digital financial inclusion on the MMIS.
The overall digital financial inclusion index, particularly the "coverage" dimension, had a significant positive and significant impact on the MMIS ( < 0.05). However, the "depth" and "digitization" dimensions were statistically insignificant ( > 0.1). Robustness checks using lagged instrumental variable approaches and double machine learning (DML) methods confirmed the stability of these findings. Heterogeneity analysis using the causal forest model revealed that digital financial inclusion had a more pronounced effect in central and western regions. Its impact in the eastern regions was relatively weaker, highlighting significant regional disparities.
Digital infrastructure in the central and western regions must be strengthened to enhance financial inclusion coverage and service capacity; the depth and quality of financial services in the eastern regions should be improved to optimize the effects of digital finance on the MMIS. Deeper integration between digital financial inclusion and the MMIS should be prompted through technological innovations to improve both equity and sustainability. This study provides valuable insights for policymakers to address regional disparities in further developing the MMIS.
数字普惠金融对医疗保险体系的影响已引起广泛关注。然而，其对中国多层次医疗保险体系（MMIS）的影响仍不明确。多层次医疗保险体系对社会福祉至关重要。它保护公民在就医期间免受经济困难，特别是在人口老龄化和医疗费用上升的情况下。通过覆盖医疗费用，多层次医疗保险体系确保人们平等获得基本医疗服务，保护人们的健康权利，防止因医疗费用导致贫困，从而促进社会稳定与公平。本研究使用2016年至2020年中国31个省份的面板数据，探讨数字普惠金融对多层次医疗保险体系发展的影响。
运用熵权法和逼近理想解排序法（TOPSIS）构建多层次医疗保险体系发展矩阵。采用面板数据回归模型分析数字普惠金融不同维度对多层次医疗保险体系的影响。
数字普惠金融总体指数，特别是“覆盖范围”维度，对多层次医疗保险体系有显著正向影响（<0.05）。然而，“深度”和“数字化”维度在统计上不显著（>0.1）。使用滞后工具变量法和双重机器学习（DML）方法进行的稳健性检验证实了这些结果的稳定性。使用因果森林模型进行的异质性分析表明，数字普惠金融在中部和西部地区的影响更为显著。其在东部地区的影响相对较弱，凸显了显著的区域差异。
必须加强中西部地区的数字基础设施，以提高金融包容性覆盖范围和服务能力；应提高东部地区金融服务的深度和质量，以优化数字金融对多层次医疗保险体系的影响。应通过技术创新促进数字普惠金融与多层次医疗保险体系的更深入融合，以提高公平性和可持续性。本研究为政策制定者解决多层次医疗保险体系进一步发展中的区域差异提供了有价值的见解。
