Health insurance, sleep, and healthcare utilization: evidence from China

Zhao, Suya (2025). Health insurance, sleep, and healthcare utilization: evidence from China. University of Birmingham. Ph.D.

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Abstract

China's health insurance system has witnessed significant changes over the past few decades. In 1998, the Urban Employee Basic Medical Insurance (UEBMI) was established. In 2002, the Urban Resident Basic Medical Insurance (URBMI) started, followed by the New Rural Cooperative Medical Insurance (NRCMI) in 2007. Subsequently, some provinces launched pilot programs to merge URBMI and NRCMI into the Urban and Rural Resident Medical Insurance (URRMI), and by 2021, this unification was largely completed across all provinces. How do these changes affect middle-aged and older adults and children in this policy context?
Firstly, this study examines the effects of three public health insurance (NRCMI, URBMI, and UEBMI) and private health insurance on the mental health of middle-aged and older adults. It also explores how transitions between these public insurances impact mental health. Additionally, it investigates the influence of the URRMI pilot policy on mental health.
Secondly, this research explores how health insurance affects children's healthcare utilization. It compares children with public health insurance to those with private insurance in terms of healthcare utilization. Furthermore, it investigates how the URRMI merger policy impacts healthcare use among children. This research also explores how insurance status affects income-related inequalities in children's healthcare utilization.
Finally, this study investigates how sleep duration and sleep quality relate to out-of-pocket (OOP) medical expenditure and the likelihood of catastrophic health expenditure (CHE) for middle-aged and older adults.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):