AUTHOR=Wang Lianjie , Hu Qi 

TITLE=The effect of urban–rural health insurance integration on consumption of middle-aged and older adult households in rural areas: evidence from China

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1260571

DOI=10.3389/fpubh.2023.1260571

ISSN=2296-2565

ABSTRACT=This study examines the effect of integrating urban-rural residents' health insurance on the consumption patterns of middle-aged and elderly households in rural areas of China. Using panel data from the China Health and Retirement Longitudinal Study (CHARLS) from 2013 to 2018, we employed a Propensity Score Matching Difference-in-Differences model (PSM-DID) to estimate the association between health insurance integration and household consumption. Our findings suggested a positive association between health insurance integration and survival consumption as well as total consumption among rural middle-aged and elderly households. The conclusion  remained valid after endogeneity treatment, robustness and placebo tests. Furthermore, we found that the impact of health insurance integration is more pronounced for middle-aged, female, and high-income rural residents' households. Integrating urban-rural residents’ health insurance raised consumption by reducing medical expenses and increasing health and life expectancy. Our study suggests that policymakers should deepen the rural medical and health system reform, improve the convenience of medical services for middle-aged and elderly families in rural areas, and improve the medical and life assistance mechanism for vulnerable groups in rural areas. Additionally, policymakers should continuously broaden rural household income channels to promote upgrading consumption structure while improving overall consumption levels.