Association between medical insurance choices and healthcare utilization among diabetes patients in The People's Republic of China : a secondary data analysis

Abstract

Since 2018, the universal medical insurance coverage rate has reached 95% in China. Due to the lack of medical and health resources and insufficient health service capacity of primary health care facilities in China, the biggest problem with the health system in China is overcrowding, especially in the utilization of outpatient services in secondary and tertiary hospitals.

This study aimed to analyze the factors Association between Medical insurance Choices and healthcare Utilization among diabetes patients among patients of age >45 years in China. The logistic regression was used to assess the association between type of hospital of elder diabetic patients and basic medical insurance in China. Data from 2018 waves of the China Health and Retirement Longitudinal Survey were used, 19,305 samples were analyzed.

This study found that among Chinese middle-aged and elderly, diabetes patients with other chronic disease increased the likelihood of using outpatient care in hospital than compared to patients without diabetes and diabetes patients without other chronic diseases. The results also found that among Chinese middle-aged and old adults, underweight people increased the likelihood of using outpatient care than healthy weight people.

Based on the findings of this study, reducing the utilization of outpatient services in secondary and tertiary hospitals in China were required improving the quality of services rendered from primary health care facilities and the utilization of primary health care facilities. As a result, this study would like to suggest that continue to promote the hierarchical diagnosis and treatment system and establish medical treatment partnerships, to improve medical insurances system.