中国流动人口灾难性医疗支出的同群效应研究——基于2014年流动人口动态监测数据视角  

Study on the Peer Effect of Catastrophic Medical Expenditure of Floating Population in Chi Based on the Dynamic Monitoring Data of Floating Population in 2014

作　　者：李涛 孙鹏威[1] 成前 Li Tao;Sun Pengwei;Cheng Qian

机构地区：[1]青岛大学经济学院,青岛266100 [2]南开大学卫生经济与医疗保障研究中心 [3]南开大学经济学院,天津300071

出　　处：《复印报刊资料（社会保障制度）》2022年第6期53-63,共11页SOCIAL SECURITY SYSTEM

基　　金：国家自然科学基金青年项目“标尺竞争下居民基本医疗保险筹资行为机理、传导机制与优化路径研究”(71904094);中国博士后科学基金面上项目“环境目标约束下地方政府居民医疗保险策略性筹资行为及传导效应研究”(2021M700413)。

摘　　要：以流动人口为研究对象,利用2014年流动人口动态监测数据实证检验中国流动人口灾难性医疗支出的同群效应。研究发现:社区除本家庭以外其他流动人口家庭灾难性医疗支出平均发生率每上升1%,则社区单个流动人口家庭的灾难性医疗支出发生率提高0.28%左右;在异质性分析中,不同户籍、地区和收入水平的流动人口灾难性医疗支出同群效应依然显著且呈现不同变化趋势;然而,在考虑同群效应下,单个家庭医疗保险对流动人口家庭的灾难性医疗支出影响不显著。进一步的社区层面研究表明:欠发达地区社会医疗保险补偿待遇相对发达地区较低、新型农村合作医疗和城镇居民基本医疗保险均为属地化管理以及流动人口的迁徒特征等因素,使得社会医疗保险难以有效分散流动人口灾难性医疗支出同群风险;而商业医疗保险因其具有补充社会医疗保险的作用,并且实行垂直化和网络化管理,在某种程度上能够提高流动人口共御灾难性医疗支出同群风险的能力。Taking the floating population as the research object,using the dynamic monitoring data of the floating population in 2014,to empirically test the peer effects of the catastrophic medical expenditures of the floating popula-tion in China.The study found that for every 1%increase in the average incidence rate of catastrophic medical expenses of other floating population families in the community,the incidence rate of catastrophic medical expenses of individual floating population families in the community would increase by about O.28%,the peer effect of catastrophic medical expenditure of floating population with different household registration,region and income level is still significant and shows different trends.However,considering the peer effect,single family medical insurance has no significant influ-ence on the family catastrophic medical expenditure of a floating population.Further research at the community level shows that,due to the relatively low compensation of social medical insurance in less developed areas,the new rural cooperative medical system(NRCMS)and urban residential insurance are both localized management,and the migration characteristics of the floating population,etc.,this makes it dificult for social medical insurance to effectively disperse the risk of catastrophic medical expenditure of floating population in the same group,while commercial medical insur-ance has the function of supplementing Social Medical Insurance which is implementing vertical and network manage-ment,to some extent,it can improve the ability of floating population to resist the risk of catastrophic medical expendi-ture in the same group.

关 键 词：流动人口 灾难性医疗支出 同群效应 多层次医疗保障 

分 类 号：C924.2[社会学—人口学] F842.684[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]