Background
Methods
Data source
Study variables
Variables | 2011 N = 17,250 | 2013 N = 18,195 | 2015 N = 19,842 |
---|---|---|---|
n (%) b | n (%) | n (%) | |
Medical Insurance Schemes | |||
NRCMS | 12,285 (72.2) | 12,879 (72.1) | 13,208 (68.8) |
UEBMI | 2101 (12.4) | 2420 (13.6) | 2810 (14.6) |
URBMI | 948 (5.6) | 1284 (7.2) | 1361 (7.1) |
PMI | 540 (3.2) | 555 (3.1) | 185 (1.0) |
NONE | 1137 (6.7) | 726 (4.1) | 1634 (8.5) |
Economic Status (Average Total Household Annual Expenditure Per Capita in 2011, 2013 and 2015/US Dollars)c | |||
Quintile 1 (255.1, 371.0, 409.7) | 2891 (20.1) | 2400 (20.2) | 2747 (20.6) |
Quintile 2 (520.3, 749.7, 869.5) | 2888 (20.1) | 2385 (20.1) | 2701 (20.3) |
Quintile 3 (803.1, 1129.3, 1368.8) | 2882 (20.1) | 2377 (20.0) | 2644 (19.9) |
Quintile 4 (1260.0, 1740.9, 2145.3) | 2847 (19.8) | 2366 (20.0) | 2620 (19.7) |
Quintile 5 (3318.9, 4396.0, 6052.2) | 2866 (19.9) | 2360 (19.9) | 2606 (19.6) |
Gender | |||
Female | 8407 (48.7) | 8816 (48.5) | 9653 (48.7) |
Male | 8841 (51.3) | 9378 (51.5) | 10,181 (51.3) |
Age | |||
[45,55] | 6895 (40.0) | 6705 (36.9) | 7410 (37.4) |
(55,65] | 6117 (35.5) | 6553 (36.0) | 6742 (34.0) |
(65, +∞) | 4238 (24.6) | 4937 (27.1) | 5690 (28.7) |
Marital Status | |||
Married or Cohabitated | 14,990 (87.0) | 15,792 (86.8) | 17,140 (86.4) |
Divorced, Widowed, Never Married, Separated | 2248 (13.0) | 2396 (13.2) | 2696 (13.6) |
Education Status | |||
Below Primary School | 4765 (27.7) | 4825 (26.5) | 5021 (25.4) |
Primary School | 6715 (39.0) | 7161 39.4) | 8673 (43.8) |
Secondary School | 3555 (20.6) | 3822 (21.0) | 3835 (19.4) |
High School and Above | 2198 (12.8) | 2375 (13.1) | 2274 (11.5) |
Registration Place | |||
Non-rural areas | 6985 (40.5) | 7348 (40.4) | 8032 (40.5) |
Rural Areas | 10,265 (59.5) | 10,843 (59.6) | 11,807 (59.5) |
Region | |||
Eastern | 5990 (34.7) | 6290 (34.6) | 6957 (35.1) |
Central | 5654 (32.8) | 5954 (32.7) | 6438 (32.5) |
Western | 5603 (32.5) | 5940 (32.7) | 6442 (32.5) |
Chronic Diseasesd | |||
No | 5566 (32.5) | 6384 (35.4) | 7523 (38.2) |
Yes | 11,573 (67.5) | 11,657 (64.6) | 12,196 (61.9) |
Self-reported Health | |||
Good | 3409 (27.7) | 4407 (25.6) | 4705 (25.4) |
Fair | 5790 (47.0) | 9032 (52.5) | 9918 (53. 6) |
Poor | 3119 (25.3) | 3765 (21.9) | 3894 (21.0) |
Depression | |||
Mild | 12,062 (70.4) | 13,661 (75.7) | 14,467 (73.4) |
Moderate | 4209 (24.6) | 3761 (20.9) | 4267 (21.6) |
Severe | 868 (5.1) | 619 (3.4) | 985 (5.0) |
Household Size | |||
1–2 | 6274 (36.4) | 6424 (35.3) | 7972 (40.2) |
3–4 | 5874 (34.1) | 6349 (34.9) | 9378 (47.3) |
≥ 5 | 5102 (29.6) | 5418 (29.8) | 2489 (12.6) |
Outpatient Service Utilization | 3117 (18.6) | 3653 (20.7) | 3615 (18.7) |
Inpatient Service Utilization | 1631 (9.6) | 2486 (13.8) | 2813 (14.3) |
Statistical analysis
Descriptive and univariate analysis
Logistic regression analysis
Results
Sample individual characteristics
Outpatient and inpatient service utilization
Variables | Outpatient Service Utilization | Inpatient Service Utilization | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
2011 N = 17,250 | 2013 N = 18,195 | 2015 N = 19,842 | 2011 N = 17,250 | 2013 N = 18,195 | 2015 N = 19,842 | |||||||
n (%) a | p | n (%) | p | n (%) | p | n (%) | p | n (%) | p | n (%) | p | |
Medical Insurance Schemes | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 | ||||||
NRCMS | 2371 (19.6) | 2706 (21.4) | 2528 (19.4) | 1129 (9.2) | 1753 (13.6) | 1830 (13.9) | ||||||
UEBMI | 328 (16.0) | 476 (20.2) | 502 (18.3) | 277 (13.2) | 418 (17.3) | 485 (17.3) | ||||||
URBMI | 163 (17.5) | 236 (18.8) | 237 (17.7) | 101 (10.7) | 179 (14.0) | 220 (16.2) | ||||||
PMI | 100 (18.7) | 93 (17.1) | 36 (19.8) | 59 (10.9) | 59 (10.7) | 27 (14.7) | ||||||
NONE | 150 (13.4) | 114 (16.0) | 227 (14.1) | 59 (5.2) | 56 (7.7) | 195 (12.0) | ||||||
Economic Status | 0.011 | 0.001 | 0.004 | 0.000 | 0.000 | 0.000 | ||||||
Quintile 1 (Poorest) | 473 (16.6) | 433 (18.2) | 440 (16.2) | 176 (6.1) | 230 (9.6) | 278 (10.1) | ||||||
Quintile 2 | 565 (19.8) | 482 (20.5) | 500 (18.8) | 233 (8.1) | 279 (11.7) | 283 (10.5) | ||||||
Quintile 3 | 528 (18.6) | 468 (20.1) | 483 (18.6) | 275 (9.6) | 314 (13.2) | 365 (13.8) | ||||||
Quintile 4 | 552 (19.7) | 470 (20.2) | 471 (18.3) | 318 (11.2) | 349 (14.8) | 421 (16.1) | ||||||
Quintile 5 | 534 (19.1) | 532 (23.2) | 512 (20.3) | 378 (13.2) | 407 (17.3) | 471 (18.2) | ||||||
Gender | 0.000 | 0.000 | 0.000 | 0.706 | 0.736 | 0.025 | ||||||
Female | 1325 (16.2) | 1558 (18.1) | 1561 (16.5) | 803 (9.6) | 1214 (13.9) | 1315 (13.7) | ||||||
Male | 1792 (20.8) | 2095 (23.1) | 2054 (20.7) | 828 (9.5) | 1272 (13.7) | 1498 (14.9) | ||||||
Age | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 | ||||||
[45,55] | 1118 (16.7) | 1242 (19.1) | 1259 (17.4) | 459 (6.7) | 661 (10.0) | 724 (9.9) | ||||||
[55,65] | 1140 (19.1) | 1290 (20.2) | 1225 (18.6) | 593 (9.8) | 900 (13.8) | 937 (14.0) | ||||||
(65, +∞) | 859 (20.9) | 1121 (23.4) | 1131 (20.4) | 579 (13.9) | 925 (19.1) | 1152 (20.5) | ||||||
Marital Status | 0.010 | 0.000 | 0.017 | 0.108 | 0.000 | 0.000 | ||||||
Married or Cohabitated | 2667 (18.3) | 3102 (20.2) | 3081 (18.4) | 1398 (9.4) | 2093 (13.4) | 2305 (13.6) | ||||||
Divorced, Widowed, Never Married, Separated | 450 (20.6) | 551 (23.9) | 534 (20.4) | 233 (10.5) | 393 (16.7) | 508 (19.1) | ||||||
Education Status | 0.000 | 0.000 | 0.006 | 0.043 | 0.000 | 0.000 | ||||||
Below Primary School | 979 (21.0) | 1057 (22.5) | 999 (20.3) | 482 (10.2) | 693 (14.5) | 824 (16.5) | ||||||
Primary School | 1252 (19.1) | 1475 (21.1) | 1564 (18.4) | 654 (9.8) | 1058 (14.9) | 1208 (14.0) | ||||||
Secondary School | 560 (16.2) | 713 (19.3) | 658 (17.6) | 314 (8.9) | 433 (11.5) | 502 (13.2) | ||||||
High School and Above | 325 (15.4) | 408 (17.9) | 390 (17.9) | 180 (8.3) | 301 (12.9) | 275 (12.3) | ||||||
Registration Place | 0.000 | 0.025 | 0.003 | 0.002 | 0.000 | 0.010 | ||||||
Non-rural areas | 1138 (16.9) | 1395 (19.8) | 1368 (17.6) | 715 (10.4) | 1081 (15.0) | 1194 (15.1) | ||||||
Rural areas | 1979 (19.7) | 2258 (21.2) | 2247 (19.3) | 916 (9.0) | 1405 (13.0) | 1619 (13.8) | ||||||
Region | 0.085 | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 | ||||||
Eastern | 1032 (17.7) | 1154 (18.8) | 1178 (17.4) | 439 (7.4) | 693 (11.2) | 827 (12.0) | ||||||
Central | 1039 (18.8) | 1142 (19.8) | 1137 (18.0) | 535 (9.5) | 806 (13.7) | 891 (14.0) | ||||||
Western | 1046 (19.2) | 1357 (23.6) | 1300 (20.7) | 657 (11.9) | 986 (16.8) | 1095 (17.2) | ||||||
Household Size | 0.000 | 0.000 | 0.758 | 0.000 | 0.000 | 0.000 | ||||||
1–2 | 1132 (18.6) | 1244 (20.0) | 1452 (18.7) | 660 (10.7) | 981 (15.5) | 1237 (15.7) | ||||||
3–4 | 977 (17.1) | 1244 (20.2) | 1695 (18.5) | 484 (8.3) | 766 (12.2) | 1276 (13.7) | ||||||
≥5 | 1008 (20.2) | 1165 (22.0) | 468 (19.2) | 487 (9.6) | 739 (13.8) | 300 (12.1) | ||||||
Chronic Diseasesb | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 | ||||||
No | 545 (10.0) | 901 (14.4) | 1015 (13.7) | 246 (4.5) | 532 (8.4) | 718 (9.6) | ||||||
Yes | 2571 (22.7) | 2736 (24.0) | 2597 (21.7) | 1384 (12.0) | 1947 (16.8) | 2093 (17.2) | ||||||
Self-reported Health | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 | ||||||
Good | 277 (8.2) | 483 (11.1) | 450 (9.7) | 141 (4.2) | 305 (7.0) | 308 (6.6) | ||||||
Fair | 952 (16.8) | 1741 (19.7) | 1742 (17.8) | 478 (8.3) | 1052 (11.7) | 1187 (12.0) | ||||||
Poor | 938 (30.9) | 1264 (34.6) | 1212 (32.1) | 579 (18.6) | 975 (26.0) | 1106 (28.5) | ||||||
Depression | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 | ||||||
Mild | 1779 (15.1) | 2388 (17.9) | 2271 (16.0) | 978 (8.2) | 1620 (12.0) | 1742 (12.1) | ||||||
Moderate | 1074 (25.9) | 1028 (27.9) | 1014 (24.3) | 510 (12.1) | 703 (18.7) | 808 (19.0) | ||||||
Severe | 263 (31.0) | 221 (37.0) | 327 (33.9) | 142 (16.4) | 156 (25.3) | 261 (26.5) |
Impacts of medical insurance schemes on healthcare utilization
Variables | Reference Group | Outpatient Service Utilization | Inpatient Service Utilization | ||||
---|---|---|---|---|---|---|---|
Coefficient | SE | p | Coefficient | SE | p | ||
Gender | Female | ||||||
Male | 0.239 | 0.037 | 0.000 | − 0.062 | 0.045 | 0.168 | |
Age | [45,55] | ||||||
(55,65] | −0.008 | 0.041 | 0.837 | 0.345 | 0.052 | 0.000 | |
(65, +∞) | 0.169 | 0.049 | 0.001 | 0.739 | 0.060 | 0.000 | |
Marital Status | Married or Cohabitated | ||||||
Divorced, Widowed, Never Married, Separated | −0.030 | 0.056 | 0.590 | 0.011 | 0.065 | 0.869 | |
Education Status | Below Primary School | ||||||
Primary School | 0.067 | 0.046 | 0.143 | 0.005 | 0.055 | 0.922 | |
Secondary School | 0.094 | 0.057 | 0.101 | −0.095 | 0.070 | 0.176 | |
High School and Above | 0.148 | 0.071 | 0.036 | −0.260 | 0.087 | 0.003 | |
Registration Place | Non-rural areas | ||||||
Rural areas | 0.053 | 0.041 | 0.192 | −0.087 | 0.050 | 0.078 | |
Region | Eastern | ||||||
Central | −0.072 | 0.043 | 0.094 | 0.182 | 0.054 | 0.001 | |
Western | 0.039 | 0.043 | 0.356 | 0.398 | 0.053 | 0.000 | |
Household Size | 1–2 | ||||||
3–4 | 0.142 | 0.040 | 0.000 | 0.126 | 0.048 | 0.008 | |
≥5 | 0.249 | 0.046 | 0.000 | 0.139 | 0.056 | 0.013 | |
Chronic Diseasesa | No | ||||||
Yes | 0.467 | 0.040 | 0.000 | 0.403 | 0.049 | 0.000 | |
Self-Reported Health | Good | ||||||
Fair | 0.630 | 0.046 | 0.000 | 0.625 | 0.059 | 0.000 | |
Poor | 1.364 | 0.055 | 0.000 | 1.584 | 0.067 | 0.000 | |
Depression | Low | ||||||
Moderate | 0.315 | 0.039 | 0.000 | 0.254 | 0.047 | 0.000 | |
High | 0.480 | 0.072 | 0.000 | 0.367 | 0.084 | 0.000 | |
Economic Status | Quintile 1 (Poorest) | ||||||
Quintile 2 | 0.243 | 0.052 | 0.000 | 0.258 | 0.068 | 0.000 | |
Quintile 3 | 0.283 | 0.053 | 0.000 | 0.609 | 0.067 | 0.000 | |
Quintile 4 | 0.317 | 0.054 | 0.000 | 0.796 | 0.067 | 0.000 | |
Quintile 5 | 0.494 | 0.056 | 0.000 | 1.058 | 0.070 | 0.000 | |
Medical Insurance Schemes | NRCMS | ||||||
UEBMI | 0.009 | 0.060 | 0.882 | 0.340 | 0.070 | 0.000 | |
URBMI | −0.172 | 0.072 | 0.016 | 0.136 | 0.082 | 0.095 | |
PMI | 0.024 | 0.109 | 0.827 | 0.226 | 0.131 | 0.083 | |
NONE | −0.422 | 0.077 | 0.000 | −0.545 | 0.100 | 0.000 |