世界经济 ›› 2017, Vol. 0 ›› Issue (3): 169-192.

• • 上一篇    

中国城乡居民医疗保险与医疗服务利用水平的经验研究

刘小鲁   

  1. 中国城乡居民医疗保险与医疗服务利用水平的经验研究
  • 出版日期:2017-03-10 发布日期:2017-01-04
  • 作者简介:刘小鲁:liuxiaolu@ruc.edu.cn
  • 基金资助:
    本文是教育部人文社科项目规划项目"管制、过度医疗与新医改背景下的付费机制改革"(13YJA790072)的阶段性研究成果。本文使用的数据来自中国健康与养老追踪调查(CHARLS),特此感谢。

The Integrated Urban and Rural Medical Insurance and the Utilization of Medical Care: Evidence from China

Liu Xiaolu   

  • Online:2017-03-10 Published:2017-01-04

摘要: 城乡居民医疗保险是中国目前实现社会医疗保险城乡统筹的主要形式。本文以CHARLS数据为基础,通过倾向匹配得分法研究该医疗保险对居民门诊和住院医疗服务利用水平的影响。结果表明,截至2013年底,中国城乡居民医疗保险没有对农业户口居民施加显著影响,也没有从总体上改变所有居民的医疗服务利用水平。此外,城乡居民医疗保险未能显著影响居民参保意愿,从而也不存在通过改变参保率进而影响医疗服务利用的间接效应。这些结果表明,中国目前的城乡居民医疗保险并没有对医疗服务利用水平产生实质性的影响。造成这一结果的主要原因可能是城乡居民医疗保险并未显著缩小医疗保险实际补偿率的城乡差异。这是进一步推进医疗保险城乡统筹着重要解决的问题。

关键词: 城乡居民医疗保险, 医疗服务利用水平, 倾向匹配得分, 处理效应

Abstract: Using the CHARLS dataset and propensity score matching, this paper studies how the integration of urban and rural medical insurance affects residents' utilization of outpatient and inpatient care in China between 2011 and 2013. The results show that the integration has neither significant overall influences nor significantly impacts medical-care utilization of rural residents. Further analysis indicates that the integration of urban and rural medical insurance has not significantly changed residents' willingness to participate in social medical insurance programs. All evidence above suggests that there is no significant effect of the integration of urban and rural medical insurance on the utilization of outpatient and inpatient care. This situation is mainly caused by the insignificant changes in compensation rates and the gaps between urban and rural areas, on which the government should focus in the future to further improve the coordination of urban and rural medical insurance.

Key words: integrated urban and rural medical insurance, utilization of medical care, propensity score matching, treatment effects