The Digital Amplifier in Medical Insurance: How Chinese Provincial Pooling Policy Optimizes Chronic Disease Management.

Background

Chronic diseases have proliferated worldwide and become one of the foremost public health challenges. The provincial pooling policy of Chinese Basic Medical Insurance Program (BMIP) (hereinafter the Policy) is conducive to coordinating healthcare resources more broadly and containing medical costs more effectively, which creates opportunities to improve chronic disease patients' health outcomes. Against this backdrop, this study aims to identify how the Policy affects chronic disease patients' health outcomes. Methodology: Utilizing data from the China Family Panel Studies (CFPS) across 31 provinces (except Hong Kong, Macao, and Taiwan) from 2010 to 2022, we constructed a panel of 26,585 observations on chronic disease patients enrolled in the BMIP. We employed a difference-in-differences (DID) design to identify the causal effects of the Policy on self-rated health (SRH) supplemented by a series of robustness checks, including event-study analysis, placebo tests, and propensity score matching DID (PSM-DID).

Results

The results show that the Policy enhances Chinese chronic disease patients' health outcomes across various robustness assessments. However, the effects exhibit heterogeneity in that the Policy can more effectively improve the health outcomes of urban patients, low-income patients, and highly educated patients. The mechanism analysis indicates that the Policy can enhance chronic disease patients' health outcomes by reducing the out-of-pocket ratio, increasing household income, and stimulating consumer expenditure. Furthermore, digital technology can amplify the effectiveness of the Policy in Chinese chronic disease patients' health outcomes.

Conclusions

These findings provide valuable insights into the potential of provincial pooling and digital technology to optimize Chinese chronic disease management.