Qin Zhou, Yue-Hui Yu, Karen Eggleston, Gordon G. Liu
{"title":"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","authors":"Qin Zhou, Yue-Hui Yu, Karen Eggleston, Gordon G. Liu","doi":"10.1155/hsc/1601163","DOIUrl":null,"url":null,"abstract":"<div>\n <p><b>Objective:</b> 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.</p>\n <p><b>Methods:</b> 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.</p>\n <p><b>Results:</b> 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.</p>\n <p><b>Conclusion:</b> 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.</p>\n </div>","PeriodicalId":48195,"journal":{"name":"Health & Social Care in the Community","volume":"2025 1","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/1601163","citationCount":"0","resultStr":"{\"title\":\"Impact of Urban–Rural Health Insurance Integration on Mental Health Among Rural Adults in China: Evidence From a Quasiexperimental Study\",\"authors\":\"Qin Zhou, Yue-Hui Yu, Karen Eggleston, Gordon G. Liu\",\"doi\":\"10.1155/hsc/1601163\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n <p><b>Objective:</b> 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.</p>\\n <p><b>Methods:</b> 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.</p>\\n <p><b>Results:</b> 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.</p>\\n <p><b>Conclusion:</b> 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.</p>\\n </div>\",\"PeriodicalId\":48195,\"journal\":{\"name\":\"Health & Social Care in the Community\",\"volume\":\"2025 1\",\"pages\":\"\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-05-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1155/hsc/1601163\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Health & Social Care in the Community\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1155/hsc/1601163\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health & Social Care in the Community","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/hsc/1601163","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
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.
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