Abstract
BACKGROUND: This study aimed to examine the impact of the development of digital inclusive finance (DIF) at the regional level on the medical and health service expenditures of urban and rural residents in Xinjiang Uygur Autonomous Region(Xinjiang), so as to help build a new DIF system, and make contributions to better serving the medical security of residents. METHODS: In this study, a large-scale questionnaire survey was used to analyze the cognition of DIF in Xinjiang and the differences in its application in the medical field. With the Xinjiang DIF index in 2022 as the explanatory variable and the total actual medical expenditure of residents as the explained variable. Regression analysis was performed using Stata 18.0 to explore the impact of regional level DIF (total index of DIF, coverage breadth, depth of use, and digitalization degree), individual-level related and regional disparity factors, on the healthcare service expenditures of residents in Xinjiang. RESULTS: For every one-unit increase in the total index of DIF, the probability of residents entering the high medical expenditure tier increases by 23.45 times. Among the sub-dimensions, the promoting effects of coverage breadth and digitalization degree are the strongest, both significantly higher than that of depth of use. Gender, age, education background, understanding of DIF, regional division, ethnic composition and other factors all have an impact on residents’ medical and health service expenditures. CONCLUSIONS: In order to promote the development of medical security for urban and rural residents in Xinjiang, it is necessary to continuously enrich the digital application scenarios of DIF for residents and give full play to the role of DIF in promoting people’s livelihood. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-025-13623-7.