| Objective:To evaluate the impact of basic medical insurance on the utilization of inpatient services of different elderly people aged 60 and above in China,and to provide decision-making reference for improving the basic medical insurance policy with Chinese characteristics.Methods:Using the public data of China family panel studies(CFPS)in 2018,the elderly aged 60 and above in China were selected as the research objects.The research variables include: Explained variable(hospitalization),Explanatory variable(basic medical insurance),control variables(gender,age,registered residence,education,marital status,family size,household per capita income(logarithm),self-rated health,chronic diseases,smoking,and drinking);Research Indicators: Taking annual hospitalization rate as the proxy index of inpatient service utilization;Grouping: The samples were divided into the insured group and the uninsured group according to whether they participated in the basic medical insurance;Subsample: The whole sample was divided into 7 subgroups of men,women,city,rural areas,low-income,middle-income,and high-income elderly according to gender,registered residence,and income;STATA 13.0 software was used to sort out and analyze the data;Firstly,the descriptive analysis method is used to describe the basic situation of each sample data.Secondly,binary logistic regression and the marginal effect model were used to analyze the influence of control variables and basic medical insurance variables on the utilization of inpatient services.Finally,the influence of basic medical insurance on the utilization of inpatient services in different elderly people was further tested and estimated by using the method of propensity score matching(PSM).Results:1、The basic medical insurance coverage rate of the whole sample of the elderly was 92.98%,and the coverage rate of basic medical insurance in each sub-sample of the elderly ranged from 91.06% to 93.83%;The hospitalization rate of the whole sample of the elderly was 23.51%,and the hospitalization rate of each sub-sample of the elderly ranged from 22.50% to 25.22%;2、(1)In control variables: Age is the influencing factor of inpatient service utilization in all the sample elderly;Gender is the influencing factor of inpatient service utilization of the whole sample elderly,urban and rural elderly and elderly with different income;Marital status is the influencing factor of hospitalization service utilization of female,urban and high-income elderly;Self rated health status and chronic diseases affect the utilization of inpatient services of all the sample elderly;Smoking affects the utilization of inpatient services of the whole sample elderly,male elderly,urban and rural elderly and high-income elderly;Drinking affects the utilization of inpatient services among the whole sample,male elderly,urban and rural elderly and the elderly with different income;(2)When other variables are controlled: Basic medical insurance affects the utilization of inpatient services of the whole sample of the elderly,and the utilization of inpatient services of the elderly who participate in the basic medical insurance is 8.9% higher than that of the elderly who do not participate in the basic medical insurance;Basic medical insurance is the influencing factor of the utilization of inpatient services for the elderly of different genders.Compared with the male and female elderly who did not participate in the basic medical insurance,the utilization of hospitalization services of the male and female elderly who participated in the basic medical insurance was 6.7% and 10.7% higher on average;Basic medical insurance affects the utilization of inpatient services by different registered residence elderly.Compared with the urban and rural elderly who did not participate in the basic medical insurance,the urban and rural elderly who participated in the basic medical insurance used 7.4% and 10.1% more hospitalization services on average;Basic medical insurance is the influencing factor of hospitalization service utilization of the elderly with different income.Compared with the low-income,middle-income and high-income elderly who did not participate in the basic medical insurance,the utilization of hospitalization services of the low-income,middle-income,and high-income elderly who participated in the basic medical insurance was 11.8%,7.8%,and 6.5% higher on average.3、The results of further test and estimation show that: Participation in basic medical insurance increased the utilization of inpatient services by 7.5%~8.7% for all the elderly;Compared with the male elderly,the female elderly who participated in the basic medical insurance used more inpatient services,and the increased range of hospitalization services utilization was 10.0%~10.8%;Compared with the urban elderly,the rural elderly who participate in the basic medical insurance used more hospitalization services,and the increased range of hospitalization services utilization is 9.1% ~ 10.9%;Compared with the middle-income and high-income elderly,the low-income elderly who participated in the basic medical insurance used more inpatient services,and the improved range of inpatient services utilization was 8.7%~10.7%.Conclusions:1、Age,gender,marital status,self-rated health status,chronic diseases,smoking,drinking,and basic medical insurance are the influencing factors of elderly inpatient service utilization.2、After controlling the effect of the related factors affecting the utilization of elderly inpatient service,the insured factors promote the utilization of inpatient services in the whole sample of the elderly in China:(1)In terms of gender: Participation in basic medical insurance promotes the utilization of hospitalization services for male and female elderly.Especially for the female elderly in China,if they have basic medical insurance,they tend to use more hospitalization services.(2)In terms of household register: Participation in basic medical insurance promotes the utilization of hospitalization services for the urban and rural elderly.Especially for the rural elderly in China,if they have basic medical insurance,they tend to use more hospitalization services.(3)In terms of income : Participation in basic medical insurance promotes the utilization of hospitalization services for the elderly with low,middle,and high incomes.Especially for the elderly with low-income in China,if they have basic medical insurance,they tend to use more hospitalization services. |
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