| Health is an important human capital in modern society,and is an important asset for both society and individuals.In particular,the level of health of older people is of great importance to the level of health of families and even the overall health of the whole population.According to the World Health Organization’s definition of an aging society,China has entered an aging society.By the end of 2019,the number of people aged 60 and above will account for 18.1% of the total population.Such a number of elderly people will inevitably create a huge demand for healthcare in our society.In China,the goal of universal health insurance has been largely achieved,but for older adults,especially those with low incomes,the cost of health care is still a major issue when it comes to accessing health care.Because "having" does not mean "using",it is important for older adults to unlock their health care needs and improve their health care behavior choices as health insurance continues to grow and affect them.As there are still both real-time and advance reimbursement systems in China,the elderly may be more affected by the different reimbursement methods due to the specificity of their group.Therefore,is it possible to improve the choice of elderly people’s health care behaviors under real-time billing as opposed to advance reimbursement? In this paper,we focus on the reimbursement method of health insurance and examine its impact on the health care behavior of the elderly.This paper uses a combination of theoretical and empirical analyses.This paper firstly compares the relevant domestic and international literature,defines the concepts of reimbursement method and health care behavior choice,and analyzes the influence mechanism.Then,we analyze the development and partial status of basic and supplemental medical insurance;the partial status of social security card-related situation and medical care-related situation of the elderly.Secondly,based on the data related to the sample of older adults over 60 years old from CHARLS2013 data and using logit models for empirical regression,the empirical results show that(1)the probability of older adults choosing outpatient medical care increases by 39.5% under the real-time billing system.(2)Real-time billing can increase the probability of elderly people going out for treatment by about 14.6%.(3)Medicare coverage and the realtime billing reimbursement method made the sample older adults more active in nonessential,non-emergency medical actions.(4)For older adults,the older they are,the more willing they are to improve the quality of their care and the more concerned they are about their health.(5)The reimbursement method has a greater impact on the lowincome elderly group.Therefore,compared with the advance reimbursement system,the real-time settlement method can make the elderly’s choice of health care behavior better than the original one,and also promote the health of the elderly.This shows that the country’s efforts to implement a comprehensive "one card" and a comprehensive real-time billing system have been very effective.Finally,the government should continue to promote the construction of social security cards,improve the level of information technology and financial settlement efficiency of local medical care,strengthen the construction of basic health care services,facilitate the entry of preventive screening programs into medical insurance,and promote the active cooperation between supplementary medical insurance and basic medical insurance. |
PDF Full Text Request