城乡居民大病保险减少了家庭灾难性医疗支出吗  

Has Urban and Rural Residents’ Critical Illness Insurance Program Reduced Household Catastrophic Medical Expenditure?

作　　者：李庆霞[1] 赵易 LI Qingxia;ZHAO Yi

机构地区：[1]厦门大学经济学院,厦门361005

出　　处：《农业技术经济》2020年第10期115-130,共16页Journal of Agrotechnical Economics

基　　金：教育部哲学社会科学研究重大课题“新时代提高保障和改善民生水平研究”(编号:18JZD043);中央高校基本科研业务费专项资金项目“我国大病保险制度政府角色与市场参与机制研究”(编号:20720151035)。

摘　　要：基于我国2012年开展城乡居民大病保险政策背景,可被视作一次自然试验,本文使用中国健康与养老追踪调查(CHARLS)2011年、2013年和2015年三年微观面板数据,通过划分两个政策期,利用双重差分模型,研究城乡居民大病保险是否减轻了家庭灾难性医疗支出。结果显示:(1)政策期一(2013年2月前)城乡居民大病保险降低家庭灾难性医疗支出发生率5.94%,政策期二(2013年2月至2015年)降低家庭灾难性医疗支出发生率3.40%;(2)城乡居民大病保险均不同程度削减了目标保障群体灾难性医疗支出,低收入和中低收入水平群体受政策影响效果最好;(3)城乡居民大病保险在不同地区的政策效果存在差异,中部地区的家庭灾难性医疗支出发生率居中,但是政策反应效果最好,西部地区灾难性医疗支出发生率最高,但是大病保险政策也产生较好减灾效果。城乡居民大病保险成为有效的减贫减灾政策。China launched an urban and rural residents’ critical illness insurance program in 2012. Based on the microscopic panel data of the China Health and Retirement Longitudinal Study(CHARLS) in 2011, 2013 and 2015, we study whether Urban and Rural Residents’ Critical Illness Insurance Program has reduced household catastrophic medical expenditure with the differences-in-differences method. The results show that the incidence of family catastrophic medical expenditures has gone down respectively by 5.94% and 3.4% after the coverage of the two policy periods. The implementation of the critical illness insurance program has also reduced the incidence of target protected groups’ catastrophic medical expenditures and has the best effect on low-income groups. For different regions, the policy effects of critical illness insurance policies are different and the incidence of household catastrophic medical expenditure in the middle region has decreased most after the program coverage. Urban and Rural Residents’ Critical Illness Insurance Program has become an effective policy to reduce poverty and disaster.

关 键 词：城乡居民大病保险 灾难性医疗支出 双重差分模型 

分 类 号：F842.684[经济管理—保险] F126.2[医药卫生—卫生事业管理] R197.1[医药卫生—公共卫生与预防医学]