城乡医保整合对中国农村成年人心理健康的影响:来自准实验研究的证据

IF 2 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Qin Zhou, Yue-Hui Yu, Karen Eggleston, Gordon G. Liu
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引用次数: 0

摘要

目的:很少有研究调查扩大和整合健康保险方案的心理影响。本研究旨在基于中国的一个大型自然实验:城乡居民健康保险计划的整合,来检验健康保险对心理健康的影响。方法:利用2011年、2013年、2015年和2018年中国健康与退休纵向研究(CHARLS)的四波数据,采用时变DID方法捕捉城乡医保整合对中国农村居民抑郁症状的影响。进一步分析了政策效应的群体异质性以及改革产生心理效应的可能机制。结果:城乡医保一体化政策实施后,农村成人平均CES-D评分下降0.424分,抑郁症状可能性下降3.5%。积极影响可能是由于成本分摊率降低以及健康满意度、社会互动和体育活动的改善。然而,整合改革对改善经济地位最低、健康状况最差以及40-49岁或70岁以上人群的心理健康影响有限。结论:城乡医保一体化对农村居民的心理有积极影响。进一步扩大城乡一体化基本医疗保险受益面,提高城乡一体化基本医疗保险受益权的公平性,可以进一步改善心理健康状况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Impact of Urban–Rural Health Insurance Integration on Mental Health Among Rural Adults in China: Evidence From a Quasiexperimental Study

Impact of Urban–Rural Health Insurance Integration on Mental Health Among Rural Adults in China: Evidence From a Quasiexperimental Study

Objective: Few studies have examined the psychological effects of expanding and integrating health insurance programmes. This study aimed to examine the effects of health insurance on mental health based on a large natural experiment in China: the integration of the rural and urban resident health insurance programmes.

Methods: Using four waves of data from the China Health and Retirement Longitudinal Study (CHARLS) collected in 2011, 2013, 2015 and 2018, this study adopted a time-varying DID approach to capture the effect of urban–rural health insurance integration on depressive symptoms among rural residents in China. The group heterogeneity of the policy effect and possible mechanisms through which the reform produced psychological effects were further analysed.

Results: The average CES-D score of rural adults decreased by 0.424 and the likelihood of depressive symptoms decreased by 3.5% after the implementation of the urban–rural health insurance integration policy. The positive effects may be due to the reduced cost sharing rates as well as improvements in health satisfaction, social interactions and physical activity. However, the integration reform had a limited impact on improving the mental health of those with the lowest economic status, the worst health status and those aged 40–49 or over 70.

Conclusion: Urban–rural health insurance integration had a positive psychological effect among rural residents in China. Additional improvements in mental health could flow from further expanding the beneficiary population and improving benefit equity under urban–rural integrated basic medical insurance.

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来源期刊
CiteScore
4.50
自引率
8.30%
发文量
423
期刊介绍: Health and Social Care in the community is an essential journal for anyone involved in nursing, social work, physiotherapy, occupational therapy, general practice, health psychology, health economy, primary health care and the promotion of health. It is an international peer-reviewed journal supporting interdisciplinary collaboration on policy and practice within health and social care in the community. The journal publishes: - Original research papers in all areas of health and social care - Topical health and social care review articles - Policy and practice evaluations - Book reviews - Special issues
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