Wang Yu, Yan Jiang, Yang Li, Yuming Zhang, Xiaojun Wang, Shuangge Ma

【Abstract】

Objective The aim of this study was to evaluate the relationship of the usage between health insurance and medical expenditure for outpatient treatment among middle-aged and elderly in three cities in Henan province, in order to identify factors associated with the usage of different healthcare facilities. Methods A cross-sectional survey for 45 years old and above subjects was conducted in three cities of Henan province in August 2013. Results A total of 1464 people were surveyed. In the past 12 months, 1134(77.5%) samples used outpatient treatment and 609(53.7%) samples used outpatient treatment more than three times. The median of the total and out-of-pocket medical expenses of outpatient treatment were 800 yuan and 600 yuan, respectively. The results showed that education, types of hospital, whether having chronic disease and person times of outpatient treatment were associated with the total and out-of-pocket medical expenses and using health insurance wasn`t associated with the total and out-of-pocket medical expenses. We also found that marital status, working in enterprise, average personal income, whether having chronic disease and type of the nearest hospital were associated with the usage of different healthcare facilities. Conclusion The medical insurance system needs to be reformed and an effective twoway referral mechanism should be established as soon as possible.

【Keywords】

Outpatient treatment, Medical expenditure, Access to healthcare