Analysis on China's Basic Medical Insurance Participation Structure and Current Situation Based on Multi-Source Database

Zhao Ning; Gao Guangying; Yang Jia

Abstract：Objective:Based on multi-source databases,the changes in the current status and structure of China's basic medical insurance participation are analyzed to identify the characteristics of the uninsured and the reasons for their non-participation,and provide decision-making references for China to improve the coverage rate in the process of modernization.Methods:Survey data from several national public databases are selected as reference comparisons,including the China Family Survey,the China Household Finance Survey,and the Chinese Social Survey,to carry out a descriptive analysis of the current status of basic medical insurance participation and changes in the structure of participation.Results:In 2022,4.7%of China's population,nearly 66 million residents,were still not be covered by the basic medical insurance system.In terms of the participation structure,employee health insurance shows that the growth rate of the number of retirees exceeds the growth rate of the number of contributors,and the participation rate of the flexibly employed people is still low,while the participation rate of newborn babies,migrant minors,college students,and elderly people over 75 years old is low in the resident health insurance.At the same time,there is a large scale of selective enrollment in the adult population.Conclusion:Individual voluntary enrollment,household registration restrictions,and information barriers are the reasons for basic medical insurance has not yet achieved universal coverage.It is recommended to expand the coverage by actively recruiting flexibly employed people to participate in the employee health insurance scheme,improve innovative mechanisms for special groups to participate in the scheme,realize cross-region and cross-sectoral mobility of participation data,and strengthen policy publicity.