Yan Jingjing
College of Philosophy, Law & Political Science, Shanghai Normal University, No. 100 Guilin Rd, Shanghai, 200233, P.R. China.
BMC Health Serv Res. 2025 Jun 5;25(1):805. doi: 10.1186/s12913-025-12946-9.
The presence of spatial inequity among provinces in China has led to emerging challenges regarding the utilization and sustainability of health insurance within the framework of universal health coverage.
This study employed the gradual implementation of the medical insurance integration policy across 31 provinces in China as a quasi-natural experiment to investigate the spatial impact of this policy change on equity within the healthcare sector. The analysis utilized the analysis of linked administrative data and applied the Spatial Durbin Model to assess the impact of the policy change across provinces.
The findings revealed that policy integration influenced per capita benefits not only within the province where it was implemented but also extended its effects to neighboring provinces, demonstrating a general spatial siphon effect. Specifically, provinces with lower per capita benefits tended to gather with their neighbouring provinces with higher per capita benefits, and vice versa.
This study provides empirical evidence for developing countries striving to enhance healthcare equity, highlighting its significance amid ongoing global discussions concerning spatial equity in medical insurance systems.
中国各省之间存在的空间不平等给全民健康覆盖框架下医疗保险的利用和可持续性带来了新的挑战。
本研究将中国31个省份逐步实施的医疗保险整合政策作为一项准自然实验，以调查这一政策变化对医疗保健部门公平性的空间影响。该分析利用了关联行政数据，并应用空间杜宾模型来评估政策变化对各省的影响。
研究结果显示，政策整合不仅影响了实施省份的人均福利，还将其影响扩展到了邻近省份，呈现出普遍的空间虹吸效应。具体而言，人均福利较低的省份往往会与人均福利较高的邻近省份聚集在一起，反之亦然。
本研究为努力提高医疗保健公平性的发展中国家提供了实证证据，凸显了其在当前全球关于医疗保险系统空间公平性讨论中的重要性。
