To examine how basic medical insurance shapes healthcare experiences among middle-aged and older adults in primary care under China's hierarchical diagnosis and treatment system, utilizing Andersen's health service utilization model.
Key Findings:
Medical expenditure rate decreased by 1.16% from 2016 to 2018.
Hospitalization rate and proportion of doctor visits increased modestly.
Basic health insurance is positively associated with satisfaction regarding healthcare facility conditions, with an average increase of 0.112 points on a 1–5 scale.
No statistically significant association found between basic health insurance and healthcare service level.
The strength of the association varies across subgroups defined by health status, age, gender, region, and household registration.
Interpretation:
Basic health insurance is linked to improved evaluations of healthcare facility conditions but not to healthcare service levels among middle-aged and older adults, suggesting a need for policy adjustments.
Limitations:
The study may not capture all factors influencing patient satisfaction, potentially limiting the understanding of the healthcare experience.
Findings may not be generalizable beyond the studied population, which could affect the applicability of the results.
Conclusion:
The relationship between insurance coverage and patient-reported primary care experience varies across different dimensions of healthcare evaluation and population subgroups, highlighting the need for targeted healthcare policies.
