Time: August 19 (Fri.), 13:30 pm – 15:00 pm (Beijing Time)

Title:   Healthcare Utilisation of the Outsiders: Evidence from the Off-site Inpatient Claim Reform in China

About the Speaker:

Xuezhu Shi is an Assistant Professor of Economics at the University of International Business and Economics. She obtained her PhD in economics at the London School of Economics. Her research and teaching interests include Development, Health and Labour Economics, with a focus on China. Her recent works are mainly on social insurance in China.

Abstract:

People were usually challenged to claim reimbursement or later reimbursements for medical expenses incurred outside of their current Chinese residence. This is due to the restrictions imposed by location-based public insurance schemes, which may impede migration. The paper investigates whether allowing people to have direct settlement for medical costs when they cannot utilise their hometown insurance can increase medical care utilisation. A reform in 2017 allowed patients to have direct settlements for the offsite inpatient care costs in most places in China. We apply the event-study approach to a new administrative dataset collected from a hospital in Eastern China. This paper is one of the first papers to use econometric methods to assess the effects of the reform. The results show that the reform increases the numbers of these offsite inpatients who visit the hospital. However, the reform induces certain moral hazard behaviours. The offsite patients are more likely to consume than regular patients, but their out-of-pocket expenditures remain relatively unchanged after the reform. Both the effects on the number of visits and out-of-pocket expenditures are not substantial. The reform also unexpectedly decreases the number of surgical procedures performed on the offsite patients. The robust results indicate that the 2017 reform on the direct settlements for offsite inpatient care costs might affect offsite inpatient care usage as planned, but the effects are limited.