Insurance Plan Choice among Cancer Patients in China: A Structured Narrative Review and Research Agenda

Hongmei Chi; Hazlina Abd Kadir; Rosman Karim

doi:10.26689/par.v9i6.12906

Hongmei Chi Post Graduate Center, Management and Science University, 40100 Shah Alam, Selangor, Malaysia
Hazlina Abd Kadir Post Graduate Center, Management and Science University, 40100 Shah Alam, Selangor, Malaysia
Rosman Karim Post Graduate Center, Management and Science University, 40100 Shah Alam, Selangor, Malaysia

DOI: https://doi.org/10.26689/par.v9i6.12906

Keywords: Cancer patients, Insurance literacy, Financial capability, Policy promotion intensity, Plan selection, China, Review

Abstract

Cancer patients in China navigate a complex and uneven insurance landscape, making plan choice critical for equitable financial protection. This study conducts a structured narrative review (2010–2025) of the Web of Science, PubMed, CNKI, and Wanfang databases, focusing on empirical research on insurance plan choice, enrollment, or switching among cancer patients and their households in China. Two reviewers independently screened studies and extracted information on key determinants and identification strategies. The evidence converges on five main determinants: insurance literacy, health knowledge, prior coverage, financial capability, and policy promotion intensity (PPI). However, most studies are cross-sectional and descriptive, with inconsistent operationalization of determinants, weak or absent mediation tests for PPI, and limited coverage of rural, elderly, and low-literacy populations. Building on these gaps, we synthesize an evidence map, propose an operational PPI index, and highlight quasi-experimental opportunities (such as staggered NRDL updates and variation in local publicity efforts) to identify mechanisms and inform more inclusive, patient-centered insurance design in China.

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