社会医疗保险制度的健康绩效及其区域异质性  

The Health Performance of Social Medical Insurance and Its Regional Heterogeneity

作　　者：何文[1] HE Wen(Hunan University,Changsha 410082,China)

机构地区：[1]湖南大学公共管理学院,湖南长沙410082

出　　处：《江西财经大学学报》2022年第1期87-97,共11页Journal of Jiangxi University of Finance and Economics

基　　金：国家社会科学基金重大项目“预防为主的大健康格局与健康中国建设研究”(17ZDA080);湖南省自然科学基金青年项目“医保异地即时结算对流动人口参保意愿及健康状况的影响研究”(2021JJ40127)。

摘　　要：基于2002-2018年我国省级动态面板数据,运用差分GMM等计量方法实证检验社会医疗保险制度的健康绩效及其区域异质性。结果表明:医疗保险作为一项重要的医疗费用分担机制,其普及程度、筹资规模以及保障水平的提高均能显著改善居民健康状况。由于不同经济状况居民的医疗服务需求弹性存在差异,使得医疗保险制度的健康绩效表现出显著的区域异质性,总体上在欠发达地区具有更强的健康保障效果。进一步从地理位置和险种类别层面进行分析发现,医保对西部地区居民的健康促进作用更强,且待遇水平更高的城镇职工基本医疗保险同样具有更好的健康绩效,并表现出更大的"亲贫性"区域异质性。Based on China’s provincial dynamic panel data from 2002 to 2018, this paper employs the Difference GMM and other methods to empirically test the health performance of China’s social medical insurance system and its regional heterogeneity. The findings show that as an important medical costs sharing mechanism, the medical insurance can improve the health sta tus of residents significantly through its improvement in its popularity, financing scale and reimbursement level. Because there are some differences in the medical service demand elasticity of the residents with different economic positions, the health performance of the medical insurance system presents significant regional heterogeneity;generally, a stronger health protection effect can be found in the underdeveloped areas. Furth analysis from the perspectives of geographical location and insurance type indicates that the medical insurance has a stronger health promotion effect on the residents in the western region,and the basic medical insurance scheme for urban employees with a higher reimbursement level has the same better health performance;meanwhile, it exhibits a greater regional heterogeneity of"pro-poverty".

关 键 词：社会医疗保险制度 健康绩效 区域异质性 差分GMM 健康公平 

分 类 号：F840.613[经济管理—保险]