# Willingness to pay for supplementary medical insurance and its influencing factors among rural residents in ethnic minority areas

## TL;DR

This study explores why rural residents in ethnic minority areas are willing to pay for supplementary medical insurance and what factors influence their decisions.

## Contribution

The study identifies key factors influencing willingness to pay for supplementary medical insurance in rural ethnic minority areas using the Andersen model.

## Key findings

- 58.98% of rural residents in Tongdao County are willing to pay for supplementary medical insurance.
- Occupation, income, and health management emphasis significantly influence willingness to pay.
- A gap exists between willingness to pay and actual behavior regarding supplementary medical insurance.

## Abstract

In recent years, the prices of medical services have been constantly rising, and supplementary medical insurance has become an important way for some residents to alleviate their heavy economic burden. Due to their special natural conditions and social environment, residents in rural areas of ethnic minorities face higher risks and costs in seeking medical treatment. Therefore, they have personalized demands for supplementary medical insurance. Therefore, studying the willingness of residents in rural areas of ethnic minorities to pay supplementary medical insurance and its influencing factors has important practical and policy significance.

Data Collection: A questionnaire was designed based on the Andersen model, and a mixed sampling approach was employed to conduct offline surveys in the market areas of five towns in Tongdao County; concurrently, electronic questionnaires were distributed via social media applications. A total of 551 valid questionnaires were obtained. Data Analysis: Data were analyzed using SPSS. Descriptive statistics, hierarchical logistic regression, and multiple correspondence analysis were applied to examine how different factors influence willingness to pay among rural residents in ethnic minority areas.

58.98% of rural residents were willing to pay for supplementary medical insurance. Multivariate analysis indicated that occupation, emphasis on health management, annual household income, payment experience, and family medical expenses in the past year significantly influenced willingness to pay (p < 0.05). Within the Andersen model framework, enabling resources exerted the strongest impact, whereas demand factors had the weakest. Furthermore, multiple correspondence analysis indicated that residents with payment experience, an annual household income between 100,000 and 150,000 yuan, and those employed in party, government, or public institutions were more willing to pay for supplementary medical insurance.

All three categories of factors within the Andersen model framework significantly affected rural residents’ willingness to pay in Tongdao County. A disconnect between willingness to pay and actual behavior concerning supplementary medical insurance was observed in the rural areas of Tongdao County. The construction and improvement of supplementary medical insurance in this context require joint efforts from all stakeholders to develop sustainably.