社会经济地位变迁与医疗服务利用不平等:2000—2011  

Changes in Socio-economic Status and the Inequality of Healthcare Utilization in China between 2000 and 2011

作　　者：赵广川[1] 顾海[1] 郭俊峰[2] 

机构地区：[1]南京大学公共卫生管理与医疗保障政策研究中心,南京210023 [2]厦门大学经济学院,福建厦门361005

出　　处：《公共管理学报》2016年第2期107-118,158,共12页Journal of Public Management

基　　金：国家自然科学基金资助项目(71373120);教育部人文社科青年项目(13YJC630135)

摘　　要：本文利用CHNS数据从一个全新的角度详细分析了21世纪以来我国居民社会经济地位对医疗服务利用不平等的影响。考虑到医疗消费支出为受限因变量,为了得到一致估计,本文在夏普里值分解之前分别构建了Tobit模型和两部模型,并对结果进行了比较。从总体上来看,我国居民医疗服务利用基尼系数虽有所下降,但始终保持在0.86以上的较高水平,其中社会经济地位是除需要类变量以外最为重要的影响因素,约占总体不平等的15%左右,进一步排序分析表明,收入的相对重要性最大,其后依次为工作状况、教育和职业。从变化趋势来看,社会经济地位的绝对贡献额和相对贡献率均具有波动上升的趋势。因此,减小医疗服务利用不平等的关键是降低社会经济地位差距,特别是收入差距。The objective of this paper is to illustrate and examine the influence of socio-economic status of Chinese residents on the inequality of healthcare utilization by using CHNS data. In order to obtain a consistent estimate and make a comparison between the results,both Tobit model and Two-part model are established.The analysis reveals that the inequality of healthcare utilization in China has declined,but still maintains at a high level of more than 0.86. The socio-economic status is the most important factor except the need variable,which accounts for about 15%.With a further sorting,it can be seen that income is successively followed by work status,education and occupation. From the trend point,both the absolute contribution and the relative rate of socio-economic status have an upward trend with a fluctuation. From a totally new perspective,this study draws on the relationship between the socio-economic status of Chinese residents and the inequality of healthcare utilization,and finds that the key to reduce the inequality of healthcare utilization is to decrease the inequality of the socio-economic status,especially income inequality.

关 键 词：社会经济地位 医疗服务利用不平等 TOBIT模型 两部模型 夏普里值分解 

分 类 号：C913[经济管理]