Effect Of Critical Illness Insurance On Poverty Reduction And Prevention In Shandong

BackgroundCritical illness usually has the characteristics of long course,difficult to cure and high cost.It not only brings a short-term economic burden of disease to the sick family,but also affects and weakens the family’s earning capacity,and may push the family into long-term poverty.Therefore,solving the problem of poverty caused by illness and returning to poverty due to illness is the key to eradicating poverty and promoting common prosperity.The Chinese government has also been committed to improving the accessibility of medical services and reducing the medical burden of the people by constantly improving the medical insurance system.Among them,the measure of critical illness insurance provides strong policy support for preventing residents from falling into poverty and returning to poverty due to illness.Many scholars have also studied this problem.However,there is still a lack of comprehensive measurement of the effect of critical illness insurance on poverty reduction and prevention.Most studies use catastrophic health expenditure to measure the poverty of residents caused by disease,only focus on the current economic risk and poverty of residents due to the impact of disease,and ignore the economic loss that residents will face in the future due to the impact of disease or other risk shocks caused by disease.ObjectiveTo do so,we have the following objectives.Firstly,understand the current situation of catastrophic health expenditure and poverty vulnerability of residents in Shandong Province,and empirically verify the poverty reduction and poverty prevention effect of critical illness insurance.Second,explore the different policy effects of critical illness insurance on different groups of people,different regions.Third,explore the possible impact mechanism of critical illness insurance on poverty prevention.Finally,it provides corresponding theoretical and implementation evidence for the deepening and optimization of critical illness insurance policy.MethodsThis study used the data of the fifth health service survey in Shandong Province and the sixth health service survey in Shandong Province,and the analysis sample includes 17 cities in Shandong Province.The data were sorted and analyzed using Stata 14.0.Based on the calculation method proposed by the World Health Organization,the incidence of catastrophic health expenditure of residents in Shandong Province was measured.Based on the three-stage feasible generalized least squares method,the poverty vulnerability of residents in Shandong Province is measured.The data are first classified according to the pre-implementation and post-implementation of the policy;before and after the implementation of the policy,it is divided into strong intervention group and weak intervention group respectively.The generalized difference in difference model is used to empirically verify the poverty reduction effect of critical illness insurance.Then use the method of sub-sample analysis to analyze the policy effects of critical illness insurance for urban and rural residents in different groups,different regions and different environments The SUEST test is used to verify the heterogeneity of policy effect.The effect of poverty prevention on critical illness insurance was discussed with interactive terms.ResultsThis study found that critical illness insurance has a good effect on poverty reduction and prevention.It significantly reduced the incidence of catastrophic health expenditure by 20.7%and poverty vulnerability by 22.1%.Among them,commercial health insurance,physical health,middle-income and above and higher education have a significant protective effect on reducing catastrophic health expenditure and poverty vulnerability.Among them,commercial health insurance,good health,middle income and above,and higher educational attainment have significant protective effects on reducing catastrophic health expenditures and poverty vulnerability.From the perspective of poverty reduction effect,its policy effect is more significant for people without chronic diseases and relatively poor groups,and the policy effect is more significant for urban survey sites,central areas,and populations in the 15-minute medical circle.From the perspective of poverty prevention effect,it can accurately identify vulnerable groups such as catastrophic health expenditure groups and low-income groups.And it can significantly reduce the poverty vulnerability of urban areas,central areas,western areas and 15-minute medical circle.Human capital,financial capital,physical capital,natural capital,and social capital are all effective channels for the role of critical illness insurance policy in poverty prevention.Conclusions and suggestionsConclusionsThe critical illness insurance in Shandong Province has a significant effect on poverty reduction and poverty prevention,and can significantly reduce the catastrophic health expenditure and poverty vulnerability of residents.Commercial medical insurance,physical health,middle income and above are protective factors to reduce catastrophic health expenditure or poverty vulnerability.And illiterate people are significantly more vulnerable to catastrophic health expenditures and poverty vulnerability.The research on the poverty reduction and prevention of critical illness insurance in Shandong Province shows that it has a good effect on the poverty reduction of the relatively poor class,the central region and the population in the 15-minute medical circle.And it has a good effect on the poverty prevention of the population with catastrophic health expenditure,low-income class,central and western regions,and the population in the 15-minute medical circle.However,in terms of poverty reduction,we should pay attention to the chronically ill,the marginalized and rural areas.And in terms of poverty prevention,we should pay attention to the effect of poverty prevention in rural areas and eastern regions.In addition,the optimization of livelihood capital is an effective channel for critical illness insurance in Shandong Province to reduce poverty.SuggestionsFirst,focus on key groups and implement precise interventions.Second,advocate prevention before disease and improve access to medical services for urban and rural residents.Third,build a multi-level medical security system and give full play to the supplementary role of commercial insurance.Last,optimize livelihood capital structure and improve livelihood sustainability of lowincome groups.