# Psychological constructs and preferences for a complementary inclusive health insurance: a hybrid choice model

## TL;DR

The study explores how people's health risk perceptions and awareness influence their preferences for a complementary health insurance in China.

## Contribution

The paper introduces psychological constructs into hybrid choice models to better understand health insurance preferences in low- and middle-income settings.

## Key findings

- Individuals with higher health risk perception prefer generous benefits but not strong government involvement.
- Greater scheme awareness increases willingness to pay higher premiums and accept lower reimbursement rates.
- Women and rural residents value the insurance more when it covers prevention and screening services.

## Abstract

Many low- and middle-income countries are affected by catastrophic health expenditures due to overstretched public health financing, indicating need for complementary inclusive health insurance solutions. Promoting these solutions requires understanding drivers, including psychological determinants, of health insurance purchase. Yet, relevant evidence is lacking. We employed hybrid choice models to analyze discrete choice experiment data and examine preferences for Huimin Insurance, a widely diffused complementary inclusive health insurance in China. We relied on KuRunData to collect our discrete choice experiment data. We found that people who regarded themselves to be at greater health risk preferred more generous benefits, while they did not value strong government involvement in product operation, design, and publicity. Higher scheme awareness was associated with a greater propensity to purchase coverage, to be willing to pay higher premium, and to accept lower reimbursement rates. High awareness coupled with a low perception of the scheme value resulted in a preference for an expanded package covering prevention and screening services. Stronger value was attributed to the Huimin Insurance among population groups that lack access to other insurance products, such as women and rural residents. By integrating psychological constructs in the decision-making analysis, we provide new evidence to guide design and promotion of appropriate health insurance schemes, especially catastrophic diseases.