Associate Professor Yao Qiang from the Social Security Research Center of Wuhan University published a paper entitled "Research on the Change Trend and Influencing Factors of Chinese Residents' Health Security Access in the New Era" in the 9th issue of the CSSCI journal Statistics and Information Forum in 2023. The full text is now forwarded and shared with readers.

【author】Guo Bingqing,Yao Qiang(corresponding author)

【Published journals】《统计与信息论坛》

【Journal level】CSSCI

【Publication time】Issue 9,2023

【Abstract】Socialism with Chinese characteristics has entered a new era, and effectively enhancing the people's sense of gain, happiness and security has become an important mission of China's medical and health system reform. However, there is no systematic study to explore the changing trend and influencing factors of Chinese residents' sense of access to medical reform since the new era. Based on the data of the comprehensive survey of China's social conditions from 2013 to 2021, this paper systematically analyzes the change trend and influencing factors of Chinese residents' satisfaction with medical services and medical security from three dimensions: social determinism, social psychology and rational choice by using the multi-layer ordered logistic regression model. The results show that since the new era, Chinese residents' satisfaction with medical services and medical security has shown a "U-shaped" trend, reaching a trough in 2015. The distribution and change trend of medical service satisfaction are good. Post-COVID, both satisfaction levels improved significantly. In terms of social determinism, residents with high education level and higher income level were less satisfied, and quasi-middle-aged residents were the least satisfied with medical insurance. In terms of social psychology, residents with lower urban and subjective social classes were less satisfied, and residents from other provinces were also less satisfied with medical insurance. In terms of rational choice, residents in areas with no medical insurance, unaffordable medical expenditures, and low per capita health fiscal expenditures were less satisfied, while residents in areas with lower government expenditures in health expenditures and higher incidence of catastrophic health expenditures were less satisfied with medical security. This study is helpful to comprehensively understand the effect of China's medical and health system reform since the new era from the perspective of demand side, grasp the internal laws and key factors of the change of sense of gain, and have certain reference value for the precise adjustment of China's medical reform policy in the new era of socialism with Chinese characteristics.

【Keywords】 medical and health system reform; health service delivery; medical insurance; Comprehensive Survey on China's Social Situation; Multi-layered ordered logistic model

【Funds】 National Natural Science Foundation of China, "Research on the Collaborative Governance Mechanism of Rural Residents' Chronic Disease Economic Risk from the Perspective of Incentive Compatibility" (72174149); National Natural Science Foundation of China Youth Project, "Research on Risk Factors and Prediction Models of Major Diseases of Urban and Rural Residents in China from the Perspective of Family Economic Risk Protection" (71603188); Humanities and Social Science Research Planning Fund of the Ministry of Education, "Research on the Formation Mechanism and Policy Optimization of Health Inequality of Floating Population from the Perspective of Medical Insurance" (21YJAZH102)