多重医疗保障对中国中老年人就医倾向和疾病自付的影响研究  

A study on the effects of multiple medical insurance on the medical treatment tendency and disease self-payment of the middle-aged and elderly in China

作　　者：张敏[1] 郑楠暄 吴胤歆[1,2,3] ZHANG Min;ZHENG Nanxuan;WU Yinxin(School of Health Management,Fujian Medical University,Fujian 350122,China;Fujian Medical University Health Policy Research Center,Fujian 350122,China;Fujian Medical and Health System Reform Research Association,Fuzhou 350122,China)

机构地区：[1]福建医科大学卫生管理学院,福建福州350122 [2]福建医科大学卫生政策研究中心,福建福州350122 [3]福建省医药卫生体制改革研究会,福建福州350122

出　　处：《福建医科大学学报（社会科学版）》2023年第1期12-17,82,共7页Journal of Fujian Medical University：Social Science Edition

基　　金：福建省医改研究会委托课题(2021B03)

摘　　要：为了解多重医疗保障政策对贫困中老年人群就医倾向的影响,以及疾病自付比例与非贫困人群的差异。利用中国健康与养老追踪调查(CHARLS)2018年数据,分别提取门诊和住院中老年人群资料,用倾向得分匹配法消除混杂因素,研究多重医疗保障政策对贫困中老年人群就医倾向的影响及其疾病自付比例。研究发现,多重医疗保障政策下贫困中老年人群与非贫困中老年人群的就医倾向差异无统计学意义;贫困中老年人群的疾病自付比例较低,其差异在10%以内。这说明尚无证据显示国家对贫困人群实施的多重医疗保障政策存在保障过度的福利主义倾向,也不存在保障不到位的状况,保障水平较为适度。To understand the impact of multiple medical insurance policies on the medical treatment tendency of poor middle-aged and elderly people,as well as medical self-payment proportion between them and other groups.Using the China Health and Retirement Longitudinal Study(CHARLS)in 2018,the data of outpatient and inpatient middle-aged and elderly people are extracted respectively.Using propensity score matching method to eliminate confounding factors,and studying the influence of multiple medical insurance policies on the medical treatment tendency of poor middle-aged and elderly people.There is no significant difference in medical treatment tendency between the selected people and other groups.Medical self-payment proportion of them is lighter than that of non poor middle-aged and elderly people,and the difference proportion is less than 10%.There is no evidence to show that the multiple medical insurance policies implemented by the state for the poor have the tendency of excessive welfare,and there is no situation that the insurance is not in place.

关 键 词：贫困中老年人群 多重医疗保障 就医倾向 自付比例 倾向得分匹配 

分 类 号：R197.1[医药卫生—卫生事业管理]