ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1535558
This article is part of the Research TopicPublic Health Outcomes: The Role of Social Security Systems in Improving Residents' Health WelfareView all 53 articles
Study on the Willingness to Enroll in the Urban and Rural Residents Basic Medical Insurance: From the Perspectives of Policy Awareness and Institutional Trust
Provisionally accepted
- 1Kunming Medical University, Kunming, China
- 2Dali Bai Autonomous Prefecture Psychiatric Hospital (The Second People’s Hospital of Dali Bai Autonomous Prefecture), Dali, China
- 3The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
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Achieving universal health coverage remains a global health priority.Understanding factors that influence individuals' willingness to enroll in basic medical insurance is essential for system sustainability.This study aims to examine the impact of policy awareness and institutional trust on the willingness of urban and rural residents to enroll in the Urban and Rural Residents Basic Medical Insurance (URRBMI), with implications for policy refinement. The goal is to improve the precision of policy implementation and encourage broader insurance participation enrollment, supporting system sustainability.A survey of 563 residents was conducted in a county of Yunnan Province, China. assessed enrollment willingness and factors influencing it. Descriptive analysis of respondent demographics was followed by multiple linear regression, using policy awareness, policy expectation and institutional trust as independent variables, and demographics as control variables, to identify significant factors affecting enrollment willingness.87.4% of respondents were enrolled in the URRBMI in this survey. The results of the survey showed that 87.4% of respondents were enrolled in the URRBMI. The regression model, with an adjusted R 2 of 0.322, showed policy awareness (coefficient=0.243, P<0.001) and institutional trust (coefficient=0.354, P<0.001) significantly and positively influenced participation enrollment willingness. Age and annual household income were also significant factors. while gender, marital status, education and so on, had no significant effects.Policy awareness and institutional trust are key determinants of enrollment willingness, with age and income playing roles. Policy education and communication should be refined, leveraging big data for targeted outreach and flexible payment options to enhance participation enrollment and system sustainability.
Keywords: URRBMI, enrollment willingness, Policy awareness, Institutional trust, Policy refinement
Received: 27 Nov 2024; Accepted: 26 May 2025.
Copyright: © 2025 Yu, He, Li, Xu, Li, Yin, Lu, He and Ma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ya He, Dali Bai Autonomous Prefecture Psychiatric Hospital (The Second People’s Hospital of Dali Bai Autonomous Prefecture), Dali, China
Luyan Li, Kunming Medical University, Kunming, China
Danni Xu, Kunming Medical University, Kunming, China
Mei He, Kunming Medical University, Kunming, China
Sha Ma, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650031, Yunnan Province, China
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