中国老年人社会健康保险计划与预防保健利用:来自中国纵向健康寿命调查的结果。

IF 2.6 0 HEALTH CARE SCIENCES & SERVICES
Cai Xu, Mack Shelley, Yen-Han Lee
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引用次数: 0

摘要

自2009年以来,中国一直致力于通过全面的医疗改革建立全民医疗保健制度。然而,关于基本社会保险与中国老年人预防保健利用(PCU)之间关系的知识,特别是作为初级覆盖,仍然有限。本研究使用2018年中国纵向健康寿命调查的数据来调查这些关联。我们分析了9952名老年人,他们的主要医疗保险来自城镇职工/居民保险(UE/URBMI)、合作医疗(新型农村合作医疗制度;NCMS)或自付(SP)。倾向评分匹配(PSM)增强了UE/URBMI或NCMS与SP覆盖对照组之间的可比性。随后的logistic回归分别检测了NCMS + SP组(n = 6580)和UE/URBMI + SP组(n = 5248)老年人主要医疗费用覆盖率与PCU之间的关系。与SP使用者相比,NCMS参与者报告PCU的几率更高(比值比:1.57,95% CI: 1.40-1.75, P < 0.05)。本研究强调了老年人健康保险类型与PCU之间的多种关联。实证结果表明,持续的政府主导的医疗保险改革可能需要继续推进,以加强社会保险框架内PCU的财政激励。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Social Health Insurance Programs and Preventive Care Utilization Among Chinese Older Adults: Results From the Chinese Longitudinal Healthy Longevity Survey.

China has aimed to establish a universal health care system through a comprehensive health reform since 2009. However, knowledge about the association between basic social insurances and preventive care utilization (PCU) among Chinese older adults, especially as primary coverage, remains limited. This study investigates these associations using data from the 2018 Chinese Longitudinal Healthy Longevity Survey. We analyzed 9,952 older adults with major medical coverage from urban employee/resident insurance (UE/URBMI), cooperative medical programs (New Rural Cooperative Medical System; NCMS), or self-payment (SP). Propensity score matching (PSM) enhanced comparability between UE/URBMI or NCMS and a control group with SP coverage. Subsequent logistic regression examined associations between major medical expense coverage and PCU for older adults with NCMS + SP (n = 6,580) and UE/URBMI + SP (n = 5,248) groups, respectively. NCMS participants had higher odds of reporting PCU compared to SP users (odds ratio: 1.57, 95% CI: 1.40-1.75, P < .001). Conversely, no significant association was observed in the UE/URBMI + SP group (odds ratio: 1.08, 95% CI: 0.93-1.24, P > .05). This study highlights diverse associations between health insurance types and PCU among older adults. Empirical results suggest sustained government-led health insurance reform may need to continue progressing to strengthen financial incentives for PCU within the social insurance framework.

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CiteScore
6.40
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