摘要
运用CHARLS 2011、2013、2015年三期数据,采用双重差分模型和准自然实验框架,分析城乡居民大病保险制度对中老年居民医疗服务利用和健康的影响及其作用机制,并从城乡和收入两个角度对制度实施效应的异质性进行探究。研究表明:大病保险制度实施能够显著促进中老年居民住院医疗服务及健康,增加中老年居民住院概率1.03%,提高住院次数0.022次,提高住院总费用10.4个百分点,总体健康水平提高0.023个单位;制度实施主要促进了农村和中等收入群体的住院医疗服务利用和健康水平的改善,对低收入人群住院医疗服务影响有限,且对城镇居民和高收入群体的影响并不显著;作用机制分析显示大病保险制度实施通过提高居民医疗服务利用进而起到改善其健康水平的作用。研究表明大病保险制度对中老年居民的住院服务利用和健康起到积极作用,但对于低收入群体的效应仍有待进一步改善。
Based on the CHARLS 2011,2013 and 2015 survey data,the study adopted the difference-in-differences model and quasi-natural experiment framework to analyze the impact and mechanism of the critical illness insurance system on medical service utilization and health among the middle aged and the elderly.And the heterogeneity of the implementation effect of the system was explored from the perspective of the household registration and income.The results showed that:The implementation of the Critical Illness Insurance System can significantly promote the inpatient medical services of urban and rural residents and improve the ove-rall health level,which significantly increase the hospitalization probability by 1.03%,increase the number of hospitalization by 0.022 times,increase the total hospitalization cost by about10.4%,and improve the overall health level by 0.023 units;The implementation of the system has a more significant impact on rural and middle-income populations.And It has limited impact on low-income population.Also it has no significant impact on urban residents and high-income groups.This study shows that the serious illness insurance system plays a positive role in the utilization of inpatient services and health of middle-aged and elderly residents,but the effect on low-income groups needs to be further improved.
作者
许新鹏
顾海
XU Xin-peng;GU Hai(School of Public Health,Nanjing Medical University,Nanjing 211166,China;School of Government,Nanjing University,Nanjing 210093,China)
出处
《人口与发展》
CSSCI
北大核心
2022年第1期16-29,共14页
Population and Development
基金
2021年江苏省优势学科三期科研创新先导青年项目(4-1-39)
国家自然科学基金面上项目“城乡居民重大疾病保障制度模式、效应评估与对策研究”(71573118)。
关键词
大病保险
医疗服务利用
健康
中老年居民
Critical Illness Insurance System
Medical Service Utilization
Health
the Middle Aged and Elderly
