Public Health Insurance System Reform and Its Impact on Health Service Utilization in Rural China: Evidence from CHNS 2000 and 2011

摘要

This study employs an empirical analysis to investigate the impact of the New Cooperative Medical Scheme (NCMS) on health service utilization in Chinese rural region using the 2000 and 2011 China Health and Nutrition Survey (CHNS) longitudinal survey data and Difference in Difference (DID) analysis method. The major conclusions are as follows. First, individual characteristic factors, enabling factors, health care need factors, and lifestyle factors affect health service utilization, which is consistent with Anderson model. Second, when controlled these factors based on Anderson model, the results indicate that the NCMS did not affect health service utilization (outpatient, inpatient, and health care examination) of individual when ill. Third, to consider the disparity of health care demand and supply, we also employ the analysis utilized the subsamples to take robustness checks. The results indicate that there is no difference statistically in health service utilization between the NCMS enrollment group and the non-enrollment group by age groups (16 - 49 aged group and 50 age and over group), income groups (High, Middle and Low-income groups), and regional groups (East, West and Central Regions). Therefore, it can be said that the NCMS did not improve either health service utilization for patients or preventative health care for rural residents in China.