The Impact of the Urban Resident Basic Medical Insurance on Health Services Utilisation in China
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The Urban Resident Basic Medical Insurance (URBMI), launched in 2007 by the State Council, aims to cover around 420 million urban residents in China.
This study aimed to assess the impact of URBMI on health services access (especially inpatient utilisation) in urban China.
Data was drawn from the recent four-wave URBMI Survey (2008–2011). Probit and recursive bivariate probit models have been adopted to handle the possible endogeneity of medical insurance in the utilisation equations.
Based on the preferred results from the unbalanced four-wave panel data, we found that the URBMI had significantly increased the likelihood of receiving inpatient treatment in the past year. However, the insurance effect on reducing the refused hospitalisation was insignificant. Finally, the URBMI had also increased the probability of using outpatient services in the past 2 weeks, although the insurance reimburses mainly against critical outpatient care.
Given that it is still early days for the URBMI scheme, the positive effect on health services utilisation is appreciable.
KeywordsMedical Insurance Health Service Utilisation Exclusion Restriction Insurance Effect Probit Estimate
We thank the Peking University China Center for Health Economics Research for providing the survey data. We are grateful to two anonymous referees for their detailed and helpful suggestions. We would also like to thank Paula Lorgelly from Monash University for helpful comments on an earlier version of this paper. Responsibility for any remaining errors lies solely with the authors.
The authors declare that no conflicts of interest exist.
Gang Chen conceptualised the research, carried out the initial analyses, drafted the initial manuscript and revised the manuscript. Gordon G. Liu supervised the URBMI Survey, conceptualised the research, and reviewed and revised the manuscript. Fei Xu contributed to the data analysis, and reviewed and revised the manuscript. Gang Chen acts as the overall guarantor of this paper.
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