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In this study, we examine the impact of health insurance coverage for chronic disease treatments in outpatient care, using recent administrative insurance claims dataset from a low\u2010income population in an underdeveloped city in China. Employing a propensity score matching and difference\u2010in\u2010differences approach, we find that outpatient coverage for certain chronic diseases increased outpatient utilization and expenses among patients with these conditions. Interestingly, these patients also increased their use of inpatient services, despite no changes in the cost\u2010sharing for inpatient care. Our findings suggest the presence of delayed care, where outpatient visits helped patients recognize the severity of their diseases and increased the demand for inpatient care. These results have important implications for the implementation of universal health coverage and the dynamics of healthcare costs in low\u2010 and middle\u2010income countries.<\/jats:p>","DOI":"10.1002\/hec.70050","type":"journal-article","created":{"date-parts":[[2025,11,10]],"date-time":"2025-11-10T08:01:32Z","timestamp":1762761692000},"page":"294-311","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Insurance Coverage for Chronic Diseases and Healthcare of Low\u2010Income People: Evidence From Chinese Administrative Data"],"prefix":"10.1002","volume":"35","author":[{"given":"Xinxin","family":"Chen","sequence":"first","affiliation":[{"name":"School of Economics Donegbei University of Finance and Economics  Dalian China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Feng","sequence":"additional","affiliation":[{"name":"School of Economics Fudan University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Economics Fudan University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dandan","family":"Yu","sequence":"additional","affiliation":[{"name":"Macquarie University Centre for the Health Economy  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2020.102347"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1257\/jep.25.2.47"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1257\/aer.20120070"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpubeco.2017.08.008"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/restud\/rdae007"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/9781316691113"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1257\/pol.20220505"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1257\/aer.100.1.193"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2013.10.008"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895\u20104356(94)90129\u20105"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1257\/aer.20181169"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2021.102539"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lansea.2023.100180"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/qje\/qjs020"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2015.10.005"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2018.11.002"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(20)30925\u20109"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.4561"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1257\/aeri.20200830"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpubeco.2023.104999"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13561\u2010021\u201000329\u20109"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10198\u2010021\u201001340\u2010x"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.4636"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2009.02.010"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/jori.12229"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2015.06.012"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1257\/pol.20190628"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/hec.4625"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpubeco.2019.104049"},{"issue":"3","key":"e_1_2_10_31_1","first-page":"251","article-title":"Health Insurance and the Demand for Medical Care: Evidence From a Randomized Experiment","volume":"77","author":"Manning W. 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