Abstract
OBJECTIVE: Previous studies have shown that health insurance and financial burden affect satisfaction with healthcare. This study aims to examine the relationship between China's outpatient pooling policies and healthcare satisfaction among middle-aged and older adults. Additionally, it investigates how demographic, socioeconomic, health status, healthcare utilization, and regional healthcare resource variables influence satisfaction levels. METHODS: Using data from the 2015 and 2018 China Health and Retirement Longitudinal Study, a mixed-effects ordered logit model was employed to assess the relationship between outpatient pooling policies and healthcare satisfaction. RESULTS: Outpatient pooling policies for Urban Employee Basic Medical Insurance were significantly associated with higher healthcare satisfaction (AOR = 1.29, 95% CI = [1.03, 1.62]), with particularly strong effects observed in the middle (AOR = 2.55, 95% CI = [1.05, 6.18]) and eastern regions of China (AOR = 3.05, 95% CI = [1.46, 6.39]). Higher financial levels of outpatient insurance protection were also associated with greater healthcare satisfaction (AOR = 1.44, 95% CI = [1.11, 1.86]). However, no significant association was observed regarding the outpatient pooling policies for Urban and Rural Residents Basic Medical Insurance. Additionally, demographic, socioeconomic, health, and healthcare utilization variables, along with regional healthcare resources, were significantly associated with healthcare satisfaction. CONCLUSIONS: This study highlights the role of implementing outpatient pooling policies, especially a higher level of protection under these policies, in improving healthcare satisfaction among middle-aged and elderly individuals in China.