The Impact of Social Health Insurance Quality on Intergenerational Medical Support for Older Adults

Background The study addresses the growing concern of intergenerational support for the older adults amidst China's rapidly aging population and changing family structures. Methods The research utilizes data collected from 1,882 valid questionnaires administered to individuals across China's eastern, central, and western provinces in 2019 and 2021. Regression and mediation effect analyses were conducted to examine the impact of social health insurance quality on intergenerational healthcare support. The study also explores the mediating role of urban-rural differences and the socioeconomic status of older adults in this impact. Results Social health insurance coverage is negatively associated with intergenerational health care cost support for the older adults, indicating that the social health insurance system plays a positive role in reducing the financial burden of family health care. Further analysis reveals that the impact of social health insurance quality on intergenerational medical support differs significantly between urban and rural areas, with the crowding-out effect being more pronounced in urban areas. The socioeconomic status of the older adults has a significant impact on the degree of intergenerational health care support, and the "crowding out" effect of social health insurance quality on intergenerational health care support is stronger among the older adults with higher socioeconomic status. The "crowding-in" effect of social health insurance quality on intergenerational health care support and intergenerational psychosocial support is stronger for older adults with higher socioeconomic status. Finally, the study found that the economic and health performance of social health insurance mediated the improvement of intergenerational health care support for the older adults. Conclusion The study concludes that optimizing the social health insurance system requires the formulation of differentiated insurance policies that consider the different socioeconomic backgrounds of older adults. Strengthening the coordination of urban and rural social health insurance policies is suggested to narrow the service gap and upgrade the level of health insurance in rural areas.