title: The effects of China's urban basic medical insurance schemes on the equity of health service utilisation: evidence from Shaanxi Province.
abstract: BACKGROUND
  In order to alleviate the problem of "Kan Bing Nan, Kan Bing Gui" (medical treatment is difficult to access and expensive) and improve the equity of health service utilisation for urban residents in China, the Urban Employee Basic Medical Insurance scheme (UEBMI) and Urban Resident Basic Medical Insurance scheme (URBMI) were established in 1999 and 2007, respectively. This study aims to analyse the effects of UEBMI and URBMI on the equity of outpatient and inpatient utilisation in Shaanxi Province, China.
  
  
  METHODS
  Using the data from the fourth National Health Services Survey in Shaanxi Province, the method of Propensity Score Matching was employed to generate comparable samples between the insured and uninsured residents, through a one-to-one match algorithm. Next, based on the matched data, the method of decomposition of the concentration index was employed to compare the horizontal inequity indexes of health service utilisation between the UEBMI/URBMI insured and the matched uninsured residents.
  
  
  RESULTS
  For the UEBMI insured and matched uninsured residents, the horizontal inequity indexes of outpatient visits are 0.1256 and -0.0511 respectively, and the horizontal inequity indexes of inpatient visits are 0.1222 and 0.2746 respectively. Meanwhile, the horizontal inequity indexes of outpatient visits are -0.1593 and 0.0967 for the URBMI insured and matched uninsured residents, and the horizontal inequity indexes of inpatient visits are 0.1931 and 0.3199 respectively.
  
  
  CONCLUSIONS
  The implementation of UEBMI increased the pro-rich inequity of outpatient utilisation (rich people utilise outpatient facilities more than the poor people) and the implementation of URBMI increased the pro-poor inequity of outpatient utilisation. Both of these two health insurance schemes reduced the pro-rich inequity of inpatient utilisation.
authors.forename: Zhongliang
authors.initials: Z
authors.lastname: Zhou
authors.forename: Liang
authors.initials: L
authors.lastname: Zhu
authors.forename: Zhiying
authors.initials: Z
authors.lastname: Zhou
authors.forename: Zhengya
authors.initials: Z
authors.lastname: Li
authors.forename: Jianmin
authors.initials: J
authors.lastname: Gao
authors.affiliation: Flinders Health Economics Group, School of Medicine, Flinders University, 216 Daws Road, Daw Park, Adelaide, SA 5041, Australia. gang.chen@flinders.edu.au.
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002681:China; D005260:Female; D019538:Health Care Surveys; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics*; D054625:Healthcare Disparities / Q000191:economics*; D006801:Humans; D007297:Inpatients; D019458:Insurance Coverage; D007348:Insurance, Health; D008297:Male; D017057:Medically Uninsured; D008875:Middle Aged; D009313:National Health Programs; D010045:Outpatients; D011203:Poverty; D015397:Program Evaluation; D012923:Social Class; D014505:Urban Population; D055815:Young Adult