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      Impact of health insurance equity on poverty vulnerability: evidence from urban–rural health insurance integration in rural China

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          Abstract

          Background

          In 2016, the Chinese government introduced an integration reform of the health insurance system with the aim to enhance equity in healthcare coverage and reduce disparities between urban and rural sectors. The gradual introduction of the policy integrating urban and rural medical insurance in pilot cities provides an opportunity to evaluate the policy impact. This study attempts to assess the policy impact of urban–rural health insurance integration on the chronic poverty of rural residents and to analyze the mechanisms.

          Method

          Based on the four waves of data from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011, 2013, 2015, and 2018, we employed a staggered difference-in-differences (staggered DID) model to assess the impact of integrating urban–rural health insurance on poverty vulnerability among rural inhabitants and a mediation model to analyze the mechanism channel of the policy impact.

          Results

          (1) Baseline regression analysis revealed that the urban–rural health insurance integration significantly reduced the poverty vulnerability of rural residents by 6.32% ( p < 0.01). The one health insurance system with one unified scheme of contributions and benefits package (OSOS, 6.27%, p < 0.01) is more effective than the transitional one health insurance system with multiple schemes (OSMS, 3.25%, p < 0.01). (2) The heterogeneity analysis results showed that the urban–rural health insurance integration had a more significant impact on vulnerable groups with relatively poor health (7.84%, p < 0.1) than those with fairly good health (6.07%, p < 0.01), and it also significantly reduced the poverty vulnerability of the group with chronic diseases by 9.59% ( p < 0.01). The integration policy can significantly reduce the poverty vulnerability of the low consumption and low medical expenditure groups by 8.6% ( p < 0.01) and 7.64% ( p < 0.01), respectively, compared to their counterparts. (3) The mechanism analysis results showed that the urban–rural health insurance integration can partially enhance labor supply (14.23%, p < 0.01) and physical examinations (6.28%, p < 0.01). The indirect effects of labor supply and physical examination in reducing poverty vulnerability are 0.14%, 0.13% respectively.

          Conclusion

          The urban–rural health insurance integration policy significantly reduced poverty vulnerability, and the OSOS is more effective than the OSMS. The urban–rural health insurance integration policy can significantly reduce poverty vulnerability for low consumption and poor health groups. Labor supply and physical examination are indirect channels of the impact. Both channels potentially increase rural household income and expectations of investment in human health capital to achieve the policy objective of eliminating chronic poverty.

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          • Record: found
          • Abstract: not found
          • Article: not found

          Difference-in-differences with variation in treatment timing

          Andrew Goodman-Bacon (2021)
          Article 0 comments Cited 531 times – based on 0 reviews     Review now
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            • Record: found
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            • Article: not found

            Process Analysis: Estimating Mediation in Treatment Evaluations

            C. M. Judd, D A Kenny (1981)
            Article 0 comments Cited 473 times – based on 0 reviews     Review now
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              • Record: found
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              Difference-in-Differences with multiple time periods

              Brantly Callaway, Pedro Sant’Anna (2020)
              Article 0 comments Cited 458 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Zhipeng Li: URI : https://loop.frontiersin.org/people/2558126/overviewRole: Role: Role: Role: Role: Role: Role: Role: Role: Role:
                Yuqian Chen: Role: Role: Role: Role: Role: Role: Role: Role:
                Jing Ding: Role: Role: Role: Role: Role: Role: Role:
                Journal
                Journal ID (nlm-ta): Front Public Health
                Journal ID (iso-abbrev): Front Public Health
                Journal ID (publisher-id): Front. Public Health
                Title: Frontiers in Public Health
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-2565
                Publication date (Electronic): 30 November 2023
                Publication date Collection: 2023
                Volume: 11
                Electronic Location Identifier: 1328265
                Affiliations
                [1] 1Qu Qiubai School of Government, Changzhou University , Changzhou, China
                [2] 2School of Economics and Management, Shanghai University of Political Science and Law , Shanghai, China
                [3] 3School of Public Economics and Administration, Shanghai University of Finance and Economics , Shanghai, China
                Author notes

                Edited by: Tang Shangfeng, Huazhong University of Science and Technology, China

                Reviewed by: Peipei Song, National Center For Global Health and Medicine, Japan; Runquan Wang, Nanjing University of Finance and Economics, China

                *Correspondence: Yuqian Chen, chenyuqian@ 123456shupl.edu.cn
                Article
                DOI: 10.3389/fpubh.2023.1328265
                PMC ID: 10722085
                PubMed ID: 38106900
                SO-VID: c9d34eab-be36-4804-9e57-c4125f1330f3
                Copyright © Copyright © 2023 Li, Chen and Ding.
                License:

                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) and the copyright owner(s) 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.

                History
                Date received : 26 October 2023
                Date accepted : 14 November 2023
                Page count
                Figures: 3, Tables: 7, Equations: 8, References: 36, Pages: 14, Words: 9886
                Funding
                The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This study was supported by the National Social Science Fund of China (grant no. 19CRK003), People’s Republic of China.
                Categories
                Subject: Public Health
                Subject: Original Research
                Custom metadata
                section-at-acceptance Health Economics

                Keywords: urban–rural health insurance integration,health insurance equity,poverty vulnerability,rural china,healthcare utilization,poverty due to illness
                Data availability:
                Keywords: urban–rural health insurance integration, health insurance equity, poverty vulnerability, rural china, healthcare utilization, poverty due to illness

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