ORIGINAL RESEARCH article
Front. Public Health
Sec. Health Economics
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1581130
This article is part of the Research TopicIntegrating Economics into Population Health: Assessing Policies and OutcomesView all 8 articles
Social medical insurance system and self-rated health: medical service utilization as the mechanism of action 1
Provisionally accepted
- Jinan University, Guangzhou, China
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Background: The fragmented segmentation of the health insurance system has led to differences in healthcare utilization and health outcomes among enrollees with different types of health insurance. This study aims to evaluate the impact of different health insurance system and further explore the pathways of health insurance.Methods: Using data from the Chinese Family Panel Studies (CFPS) conducted by the China Social Science Survey Center of Peking University in 2018 and 2020, this study employed logit regression model to estimate the impact of different types of health insurance systems on health outcomes. Additionally, healthcare utilization was introduced as a mechanism variable for analysis.Results: The findings indicate that Urban and Rural Residents Basic Medical Insurance (URRBMI) does not significantly improve health outcomes. In contrast, Urban Employee Basic Medical Insurance (UEBMI) significantly enhances the health status of insured individuals. The influence of medical insurance systems on health exhibits heterogeneity, with education level and regional disparities significantly affecting the effectiveness of these systems. Patterns of healthcare utilization, including inpatient and outpatient medical expenditures and the use of large hospitals, play a crucial role in enhancing the health of insured individuals under UEBMI.Conclusion: There are significant differences in the impact of various medical insurance systems on the health of insured individuals. UEBMI demonstrates a superior effect in improving the health of insured individuals compared with URRBMI. Future efforts should focus on enhancing the overall planning and coordination of medical insurance, narrowing benefit disparities, and promoting the implementation of a tiered medical system.
Keywords: urban and rural residents basic medical insurance1, urban employee basic medical insurance2, self-rated health3, healthcare utilization4, health equity5
Received: 04 Mar 2025; Accepted: 22 May 2025.
Copyright: © 2025 Zhou, Li and Lv. 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: Jian Zhou, Jinan University, Guangzhou, China
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