卫生服务可及性如何影响农民工主观生活质量?——基于流动人口健康重点领域专题调查的证据  

How Does theAccessibility to Health ServicesAffect the Subjective Life Quality of Migrant Workers? EvidenceBasedonThematicSurveyinKey AreasofHealthofMigrantPopulation

作　　者：邓睿 DENG Rui

机构地区：[1]西南政法大学经济学院 [2]西南政法大学制度经济学研究中心

出　　处：《中国农村观察》2022年第2期165-184,共20页China Rural Survey

基　　金：重庆市教委科技项目“健康权益可及性对农民工就业质量提升的多维影响及驱动机制研究”(编号:KJQN202000304);重庆市教委科技项目“卫生服务可及性影响农民工可行能力的效应评估与机制识别研究”(编号:KJQN202100303);重庆市自然科学基金面上项目“禀赋-理性生计资本范式下返乡农民工生计决策分类表征与驱动机制研究”(编号:cstc2021jcyj-msxm1505)的阶段性研究成果。

摘　　要：流入地卫生服务可及性不仅关乎农民工健康状况,还可能对其主观福利产生潜在影响。本文利用流动人口专题调查数据评估了卫生服务可及性对农民工主观生活质量的影响及作用机制。研究发现,在控制了潜在内生性后,卫生服务的可获得性、空间可达性、适切性对农民工主观生活质量的提升产生了强弱不一的作用。可获得性水平的提升可以使农民工拥有更高的生活满意度,并对其社会反馈行为产生正向影响;空间可达性和适切性水平的提升能够在一定程度上提高农民工社会反馈行为的积极性。机制检验证实,卫生服务可及性水平的提升可以使农民工卫生习惯趋同于城市居民,帮助农民工养成健康就诊行为,提高这一群体的主观生活质量。卫生服务可及性对农民工主观生活质量的影响存在一定的代际和性别异质性。此外,卫生服务可及性对农民工主观生活质量的提升并非完全来自患病农民工样本的“正向溢出效应”,但患病经历是卫生服务可及性正向影响农民工社会反馈行为的重要因素。The accessibility to health services in inflow areas is not only related to the health status of migrant workers, but may also have a potential impact on their subjective welfare. This study uses the thematic survey of migrant population to evaluate the impact and possibility mechanism of the accessibility to health services on the subjective quality of life of migrant workers. The study finds that after controlling the potential endogenous biases, the availability, spatial accessibility and appropriateness of health services may all have different effects on the improvement of the subjective quality of life of migrant workers. Specifically, the improvement of the level of availability can make migrant workers have higher life satisfaction and have a positive impact on their social feedback behavior. The improvement of spatial accessibility and appropriateness level can increase the enthusiasm of migrant workers to participate in social feedback behavior to a certain extent. The mechanism test confirms that the improvement of the accessibility to health services can accelerate the convergence of migrant workers and urban residents’ health habits, help them develop healthy medical treatment behaviors, and improve their subjective quality of life.At the same time, there is a certain degree of intergenerational and gender heterogeneity in the impact of the accessibility to health services on migrant workers’ subjective quality of life. In addition, the improvement of the subjective quality of life by the accessibility to health services is not entirely due to the “positive spillover effect” of the sample of sick migrant workers. However, the experience of illness still plays an important rolefor theimpact ofthe accessibility to health serviceson the socialfeedbackbehavior of migrantworkers.

关 键 词：农民工 卫生服务可及性 主观生活质量 健康素养 

分 类 号：C913.7[经济管理]