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SP11-85: Medical Insurance Participation and the Novel Coronavirus Epidemic in Hubei, China: An Empirical Study based on CLDS





Poster Presenter

      Junliang Zhang

      • Student
      • University of Macau
        Macao

Objectives

To know about the overall situation of medical insurance participation and risk of infection in Hubei; to verify the differences on implementation of the medical insurance system among cities in Hubei; to provide health policies for COVID-19 patients’ health so as to increase their reimbursement.

Method

We summarized the data of 7 cities in Hubei from CLDS, and calculated the uninsured rate. A model was used to get the risk indexes of contagious disease based on the residents' self-assessment. We also analyzed the correlation between them and the number of cases and deaths of the COVID-19 epidemic.

Results

All data of individuals surveyed in the CLDS from Hubei (n=801) was collected. Results showed that Wuhan, the outbreak place of COVID-19, has the second highest uninsured rate (10.78%) of 3 major basic medical insurance and the highest risk index of contagious disease among 7 cities in Hubei Province. 75% of the uninsured people by 3 major basic medical insurance do not have any other medical insurance in Wuhan, which is higher than the average of the entire Hubei Province (65.57%). Among those people who don't participate in any type of medical insurance in Hubei (n=39), none of them thought that their risks of contagious disease infection were very high. 1, 11, 23, and 4 out of 39 individuals thought their possibilities of infection were "more likely", "less likely“, "very unlikely" and "don't know/unclear", respectively. From high to low, the rankings of uninsured rate and risk index are Jingzhou (11.11%), Wuhan, Huanggang (6.94%), Xianning (6.33%), Xiaogan (4.00%), Jingmen (3.26%), Yichang (1.72%), and Wuhan, Jingzhou, Huanggang, Yichang, Xianning, Xiaogan, Jingmen, respectively. Uninsured rate is significantly correlated to the risk index [?(pho)=0.750, p<0.05], while neither uninsured rate nor risk index is significantly correlated to the number of cases and deaths in the epidemic as of Feb. 12, 2020.

Conclusion

Because cities in the east of Hubei are facing greater challenge of COVID-19, they need to expand the coverage of basic medical insurance so as to catch up with the western cities in Hubei. In terms of the situation in Wuhan, the shortage of medical insurance coverage may contribute to the further deterioration of the epidemic. Therefore it is necessary for the Chinese central government to take further steps, including greater funding for healthcare and residents' medical insurance, to respond to further developments in the epidemic. What's more, COVID-19 is recommended to be included in the reimbursement of urban and rural residents' critical illness insurance in Wuhan and even other cities across the country. The spreading contagious disease in China is more related to migration, not correlated to the medical insurance participation. However, the correlation between uninsured rate and risk index of contagious disease infection may indicate the strength of people's awareness of public health and self-care. For those areas where people were less concerned about medical insurance, the local governments should promote people's health education, especially those who thought they were very unlikely to be infected by contagious diseases.