Research On The Effect Of Urban And Rural Health Insurance Reform On Medical Behavior Of Rural Middle-Aged People

China nowadays has been facing the rapid development of aging population,which leads to a distinctively high demand of health care needed by the aged or even middle-aged people.The gap between rural and urban China has put the seniors living in the rural in the hardships of acquiring health service.As a mediator,health insurance was designed to relieve financial pressure of people seeking for medical service and spread the would-be risks for them.However,the difference of the designation of the health insurance serving for the urban and the rural makes those aged rural people facing relatively higher costs,and thus brings an imparity between the rural and the urban.Under such a background,China's government has tried to make a combination of urban and rural health insurances via some reforms,which may help to eliminate the imparity.This research bases on the reforms and policies relating to such a health insurance combination,trying to understand whether such a reform would affect medical behaviors of rural seniors.On the basis of strategies of urban and rural health insurance reform,the theory of health demand and Andersen health service model,this thesis builds its econometrics models.By employing the CHARLS2011 and CHARLS2015,a panel data is built.All the components of the samples observed by this research are Chinese rural seniors,and their medical behaviors are measured by expenses of outpatient service,frequencies of outpatient service,expenses of hospitalization,frequencies of outpatient service.The year of the health insurance combination in the prefecture-level cities is considered as a variable referring to the implement of such a reform.Additionally,the controlled group is composed by those seniors living in the areas in which the health insurance combination has not been implemented.Next,to estimate the effect of health insurance combination on people's medical behaviors,Two-Part Model and DDD model is employed.After that,extra regressions are added to guarantee the robustness of estimation.Overall,conclusions are made as followed.Firstly,the combination of urban and rural health insurance does not improve the outpatient medical behaviors of rural seniors significantly,in that no increase is found on the frequencies and expenses of outpatient services.Secondly,such a combination,while does not help to boost the frequencies of hospitalization services,it does help to save the expenses for rural seniors who have services of hospitalization.Thirdly,gender,age,attending social activities,sleeping quality and health state is proved to affect rural seniors' medical behaviors.According to the findings mentioned above,some solutions are suggested.Firstly,local governments should be responsible for the advertisement of policies according to health insurances and encouraging people to use medical services timely.Secondly,rural medical facilities should be updated or remolded,and distribution of medical resources should take consideration the priority of rural areas.Thirdly,related departments should shed some lights on the commercial insurances,so that the quality of social health insurance could be enhanced,and the designation of such insurance could be more compatible for China's current situationFinally,some particularities of this thesis should be mentioned.Firstly,the year of the health insurance reform is relatively exogenous,therefore employing such a variable could help to solve the possible estimation bias partly.Secondly,using Two-Part Model and DDD Model could control some of the random errors brought by those samples whose medical expenses are not available to be observed.Finally,urban samples are added into the regressions as the controlled group for the availability of stationary trend test required by DID Model.