摘要
文章利用2017年中国流动人口动态监测调查数据,从医疗保险制度的模式差异与参保地点差异两个维度讨论了医疗保险制度对流动人口在居住地卫生服务利用的影响。研究结果表明,参加任何一种社会医疗保险制度均显著提高流动人口在居住地的卫生服务利用,无论参加城镇职工医疗保险还是城乡居民医疗保险,对流动人口的卫生服务利用没有显著差异。进一步分析发现,无论参加何种社会医疗保险,在居住地参保均显著提高流动人口的卫生服务利用。采用PSM方法进行稳健性检验,结论依然成立。文章认为,现行医保制度存在的“地域区隔”构成了影响流动人口卫生服务利用的制度藩篱,应尽快解决跨统筹地区就医结算的“不便捷”,合理配置医疗卫生资源均衡分布,消除地方本位主义,鼓励地方政府探索制度创新,吸纳更多的流动人口参加居住地医疗保障体系。
Based on the 2017 China Migrants Dynamic Survey (CMDS), this paper investigates the impact of medical insurances, particularly the insurance type and the place, on the health service utilization of floating population in their residence. The results show that, compared with the floating population who did not participate in any social medical insurance, participating in a social medical insurance program can significantly improve the floating population’s health service utilization level in their residence. Compared with the floating population who participate in the medical insurance for urban and rural residents, participating in the medical insurance for urban workers has no significant impact on the health service utilization of floating population in their residence. Further analysis shows that migrants who have medical insurance in current residence, no matter which type, compared with those participated in hukou origin hometown or other places, have significantly higher level of health service utilization. The resutls using PSM method confirm the robustness of the key findings. This paper claims that the location of medical insurances makes significant difference, while the type does not, in affecting migrants’health service utilization level. The existing medical insurance system of“geographical division”constitutes an institutional barrier affecting the use of health services for the floating population. The govern ment should solve the“inconvenient”settlement of medical treatment in cross-urban areas as soon as possible, allocate the balanced distribution of medical and health resources rationally, eliminate local departmentalism, straighten out inter-governmental relations, and encourage local governments to explore institutional innovation to absorb more floating population to participate in the medical insurance system in their residence.
作者
孟颖颖
韩俊强
Meng Yingying;Han Junqiang
出处
《中国人口科学》
CSSCI
北大核心
2019年第5期110-120,128,共12页
Chinese Journal of Population Science
基金
国家社科基金青年项目“医疗保险制度对农民工消费的影响研究”(编号:15CGL046)的阶段性成果
