ArticlePloS one2026
The impact of China's employee basic medical insurance outpatient pooling scheme on outpatient healthcare utilization among middle-aged adults.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study evaluates the association between China's Employees' Basic Medical Insurance (EBMI) outpatient pooling policy and outpatient service utilization among middle-aged insured individuals (aged 45-60). By analyzing outpatient service use, visit frequency, and out-of-pocket (OOP) expenditures, the study documents utilization patterns associated with the policy and explores their implications for healthcare-seeking behavior among middle-aged enrollees, providing evidence that may inform future adjustments to outpatient coverage design.
methodsUsing cross-sectional data from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS), this study employed a logistic regression model to examine the effect of the outpatient pooling policy and different levels of outpatient benefit coverage on the probability of outpatient visits. A zero-inflated negative binomial regression model was used to analyze the impact on the frequency of outpatient visits, and a Tobit model was applied to assess its effect on out-of-pocket outpatient expenditures. Although the analysis relies on 2018 pilot data, the core institutional mechanisms of outpatient pooling were retained in the post-2021 national framework, suggesting that behavioral responses observed in pilot regions may still be informative under the current reform framework.
resultsImplementation of the outpatient pooling policy was associated with a 5.0 percentage points higher probability of outpatient visits (p < 0.05) and a significantly higher visit frequency (IRR = 1.80, p < 0.01). Predictive estimates indicate that expected out-of-pocket expenditure in policy regions was approximately 48% higher than in non-policy regions (p < 0.05). Regions with higher levels of outpatient benefit coverage exhibited stronger utilization responses. In addition, individuals with multiple chronic conditions demonstrated significantly greater outpatient healthcare utilization.
conclusionsThe EBMI outpatient pooling policy was associated with higher outpatient service utilization, suggesting improved access to previously unmet outpatient healthcare needs. However, additional adjustments may be required to better address the needs of patients with chronic conditions and to strengthen primary healthcare resources, thereby contributing to improvements in equity and efficiency.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.