新型农村合作医疗制度的健康效应  

Health effect of new rural cooperative medical system

作　　者：章蓉[1] 曹乾[1] 路云[1] 范涛[1] 孙钰[1] 陈露[1] 

机构地区：[1]东南大学公共卫生学院医疗保险系,南京210009

出　　处：《上海交通大学学报（医学版）》2014年第1期88-94,共7页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(71103033)~~

摘　　要：目的探究新型农村合作医疗制度(新农合)在农民健康相关指标改善中的作用,定量评估新农合政策的实施效果。方法基于政策效果评价的倍差法(DID模型)和Probit模型对中国2004年和2009年新农合制度的参合数据进行健康效应的实证研究,样本分为对照组(n=1 058)和参合组(n=2 879),比较两组农民在新农合实施前(2004年)和实施后(2009年)健康效应评价指标(4周患病率、体质量指数和自评健康)的变化情况。结果新农合制度对农民的体质量指数有一定的促进作用(r=-0.139,P=0.036,OR=0.871),在职、年龄和收入是体质量指数异常的相关因素。新农合制度对自评健康也有一定的促进作用(r=-0.214,P=0.001,OR=0.807),性别、年龄、收入水平、家庭规模以及婚姻状况对健康自评有影响(P<0.05);新农合制度对降低患病率效果不显著。结论为更加有效地促进新农合对健康相关评价指标的积极作用,应注意加强健康生活理念的宣传力度,培养健康的生活方式,重视医疗保健服务以及形成合理的就医行为。Objective To explore whether the new rural cooperative medical system （NCMS） had any effect on promoting farmers＇ related health index, and to quantitatively evaluate the implementation of NCMS. Methods Data of rural residents participating NCMS in 2004 and 2009 were evaluated with the different to different method （ DID model） and Probit model. The samples were divided into control group （ n = 1 058） and participation group （n = 2 879）. The changes of health effect evaluation index （four weeks prevalence rate, body mass index, and self-reported health） of the two groups were evaluated. Results The NCMS was certain to promote the body mass index （ r = - 0. 139, P = 0. 036, OR = 0. 871） and self-reported health （r = - 0. 214, P = 0. 001, OR = 0. 807）, but had no significant effect to the prevalence rate. Job, age, and income were relevant factors for abnormal body mass index. Gender, age, income, family size, and marital status had influence on self-perceived health value （ P 〈 0.05）. Conclusion For more effectively promoting the NCMS effects on health related index in rural life, more attention should be paid to broadcast the health life concept; healthy life style should be developed; and the medical and health care service should be emphasized.

关 键 词：新型农村合作医疗制度 倍差法 PROBIT模型 健康效应 

分 类 号：R197.1[医药卫生—卫生事业管理]