Effects of China's urban basic health insurance on preventive care service utilization and health behaviors: Evidence from the China Health and Nutrition Survey

Dong, WY;Gao, JM;Zhou, ZL;Bai, RH;Wu, Y;Su, M;Shen, C;Lan, X;Wang, X

[Dong, Wanyue; Lan, Xin] Xi An Jiao Tong Univ, Sch Publ Hlth, Hlth Sci Ctr, Xian, Shaanxi, Peoples R China.
[Gao, Jianmin; Zhou, Zhongliang; Wu, Yue; Su, Min; Shen, Chi] Xi An Jiao Tong Univ, Sch Publ Policy & Adm, Xian, Shaanxi, Peoples R China.
[Zhou, Zhongliang; Bai, Ruhai] Xi An Jiao Tong Univ, Global Hlth Inst, Hlth Sci Ctr, Xian, Shaanxi, Peoples R China.
[Wang, Xiao] Xian Jiaotong Liverpool Univ, Int Business Sch Suzhou, Suzhou, Jiangsu, Peoples R China.

PLOS ONE

Volume:13 Issue:12

DOI:10.1371/journal.pone.0209890

Publication Year:2018

JCR:Q2

CAS JCR:3区

ESI Discipline:Multidisciplinary

Latest Impact Factor:3.24

Document Type:Journal Article

Identifier:http://hdl.handle.net/20.500.12791/001194

Abstract

Background Lifestyle choices are important determinants of individual health. Few studies have investigated changes in health behaviors and preventive activities brought about by the 2007 implementation of Urban Resident Basic Health Insurance (URBMI) in China. This study, therefore, aimed to explore whether URBMI has reduced individuals' incentives to adopt healthy behaviors and utilize preventive care services. Methods Data were drawn from two waves of the China Health and Nutrition Survey. Respondents were categorized according to their insurance situation before and after the URBMI reform in 2006 and 2011. Propensity score matching and difference-in-differences methods were used to measure levels of preventive care and behavior changes over time. Estimations were also made based on gender, self-reported health, and income. Results We found that URBMI implementation did not change residents' utilization of preventive care services or their smoking habits, drinking habits, or other risky behaviors overall. However, the likelihood of sedentariness did increase by five percentage points. Females tended to be more sedentary while males were less likely to drink soft drinks. Residents with poor self-reported health exercised less while those who reported good health were more likely to be sedentary. Low-and middle-income residents were likely to be sedentary while middle-income people tended to smoke after becoming insured. Conclusion Since URBMI implementation, some unhealthy behaviors like sedentariness have increased among those who were newly insured, and different subgroups have reacted differently. This suggests that the insurance design needs to be optimized and effective measures need to be adopted to help improve people's lifestyle choices.

Copyright 2006-2020 © Xi'an Jiaotong-Liverpool University 苏ICP备07016150号-1 京公网安备 11010102002019号