Luo Hui, Fu Jiechuan, Xiao Mimi
School of Public Health, Research Center for Medical and Social Development, Chongqing Medical University, Chongqing, China.
Front Public Health. 2025 Jul 2;13:1559856. doi: 10.3389/fpubh.2025.1559856. eCollection 2025.
The integration policy of urban and rural medical insurance of China is an important policy benefiting the people, aimed at promoting health equity and improving the level of medical security. In the present analysis, we aimed to identify the association between health policy implementation and child health taking China for example.
Data were drawn from the child sample of China Family Panel Studies (CFPS) 2012-2018, totaling 11,003 items, and the number of illness times, height-for-age -score, weight-for-age -score and BMI-for-age -score were served as health indicators. This paper used the difference-in-differences model to explore the impact of urban and rural medical insurance integration policy on children's health and the moderating effect model to analyze the mechanism of action.
Our study found that urban-rural medical insurance integration has a positive impact on reducing children's illness and improving nutritional status, particularly among middle socioeconomic status and rural children. In provinces that implemented the policy in 2017, the realization of the integration policy decreased the number of times of children getting sick ( = -0.097, < 0.05), and increased the BMI-for-age -score ( = 0.194, < 0.05). In addition, participation in commercial medical insurance enhanced the positive impact of the integration of urban and rural medical insurance on children's physical fitness. However, in provinces that implemented the policy in 2018, policy implementation did not change any health indicators. This may suggests a trend where the health promotion effect of the integration policy gradually emerged over time.
It is hoped that this study will provide a policy basis and institutional reference for policy makers to construct and develop the children's health insurance system.
中国城乡医疗保险一体化政策是一项惠及民众的重要政策，旨在促进健康公平，提高医疗保障水平。在本分析中，我们以中国为例，旨在确定卫生政策实施与儿童健康之间的关联。
数据取自2012 - 2018年中国家庭追踪调查（CFPS）的儿童样本，共11003项，患病次数、年龄别身高得分、年龄别体重得分和年龄别BMI得分作为健康指标。本文采用双重差分模型探讨城乡医疗保险一体化政策对儿童健康的影响，并采用调节效应模型分析其作用机制。
我们的研究发现，城乡医疗保险一体化对减少儿童疾病和改善营养状况有积极影响，特别是对中等社会经济地位的儿童和农村儿童。在2017年实施该政策的省份，一体化政策的实施减少了儿童患病次数（β = -0.097，P < 0.05），并提高了年龄别BMI得分（β = 0.194，P < 0.05）。此外，参加商业医疗保险增强了城乡医疗保险一体化对儿童身体素质的积极影响。然而，在2018年实施该政策的省份，政策实施并未改变任何健康指标。这可能表明一体化政策的健康促进效果随时间逐渐显现的趋势。
希望本研究能为政策制定者构建和发展儿童健康保险体系提供政策依据和制度参考。
