Study On The Impact Of Direct Settlement Of Cross-provincial Medical Treatment Under Basic Medical Insurance On The Residency Intentions Of The Migratory Population

The participation rate in China’s basic medical insurance maintains a stable level of over 95%,establishing the largest and most comprehensive basic medical security network in the world.However,due to regional development disparities and insufficiencies,there exist corresponding issues in healthcare and social security.In the realm of healthcare,there are significant gaps in funding,accessibility,and usage of medical services between urban and rural areas,and between developed and underdeveloped regions.China’s basic health insurance system operates under a unified management system at the city and county levels.In the context of unequal medical resource allocation and large-scale,normalized population migration,the scale of local medical treatment for insured individuals living and working outside their original region has increased.In the absence of direct settlement of medical insurance,migratory populations seeking medical treatment elsewhere must pay the full medical costs at local institutions and seek reimbursement at their home location,posing a certain hindrance to their medical treatment.This inconvenience dilutes the effect of medical insurance,leading to difficulties in seeking treatment,medical reimbursement,and reluctance to seek medical attention due to illnesses.This affects the living experience and willingness to stay of the migratory population in their new location.In 2016,China initiated the nationwide medical insurance network,first carrying out a pilot project for cross-provincial inpatient medical expense settlements,followed by the resolution of instant settlement and reimbursement for crossprovincial inpatient and outpatient expenses.This policy emerged from the livelihood issues caused by the inconvenience of seeking medical treatment across different regions.If it can be popularized and promoted nationwide,populations seeking medical treatment in different places will enjoy more convenient medical resources and subsequent reimbursement procedures.This article,with the popularization and promotion of direct settlement for medical treatment in different places as the starting point,focuses on the direct settlement of basic medical insurance for medical treatment in different places,and its impact on the willingness of the migratory population to stay.First,we clarify the factors influencing the willingness of the migratory population to stay,comb through the effects of social security and accessibility of medical services on the willingness to stay,and discover that the settlement of medical insurance networking makes the reimbursement method more convenient,has a positive impact on the use of medical services by the migratory population,and promotes the willingness of the migratory population to stay through the improvement of medical service utilization.Then we analyze the current situation of China’s basic medical insurance system and the medical treatment of the migratory population.Next,based on the relevant data of the migratory population aged 15-64 in the National Migratory Population Monitoring Data(CMDS)2018,we use the binary Logistic model to study the impact of direct settlement of cross-provincial inpatient expenses on the willingness of the migratory population to stay.Overall,the direct settlement method makes the medical use of the migratory population better than before,and to some extent enhances their willingness to stay.This shows that the national implementation of the policy of direct settlement for medical treatment in different places has significant effects.Based on empirical conclusions,this article provides the following policy suggestions: continue to promote the direct settlement of medical treatment in different places,effectively popularize the method of direct settlement of outpatient medical expenses,and continuously improve the settlement efficiency.