居民医保一体化对城乡消费差距的影响及空间效应——来自278个地级及以上城市的经验证据  

The Impact and Spatial Effect of Medical Insurance Integration on Urban-rural Consumption Gap:Empirical Evidence from 278 Cities at Prefecture Level and above

作　　者：朱健[1] 李子芳 陈湘满[1] ZHU Jian;LI Zifang;CHEN Xiangman(Business School,Xiangtan University,Xiangtan 411105,Hunan,China)

机构地区：[1]湘潭大学商学院,中国湖南湘潭411105

出　　处：《经济地理》2023年第5期108-116,共9页Economic Geography

基　　金：国家社会科学基金项目(20BJL078);湖南省研究生科研创新项目(CX20220629)。

摘　　要：居民医保一体化作为完善我国多层次医疗保障体系的一项重要举措,对于实现城乡统筹、促进消费公平、提高社会福利具有重要意义。在梳理我国居民医保一体化政策实施情况的基础上,基于2006—2019年278个地级及以上城市的面板数据,利用渐进DID、空间DID等方法探究居民医保一体化对城乡消费差距的影响效应和作用机制。结果表明:(1)居民医保一体化政策与城乡消费差距指数存在一定时空耦合特征,分别呈现由沿海到内陆逐步蔓延和由内陆到沿海逐渐缓和的趋势,在较早进行政策试点的珠三角、长三角、山东半岛等区域,其城乡消费差距指数也明显更低;(2)居民医保一体化能够显著缓解当地城乡消费差距,且存在空间溢出效应,会减缓经济发展水平相似城市的城乡消费差距,而加剧地理相邻城市的城乡消费差距;(3)居民医保一体化政策通过缩小城乡收入差距和减少预防性储蓄来缓解城乡消费差距,并且对消费差距的影响效应在不同经济聚集区域、不同经济发展水平城市具有异质性。As an important measure to improve our multi-level medical security system,the integration of resident medical insurance is of great significance to realize the urban and rural integration,promote the fairness of consumption and improve the social welfare.Based on the review of the policy implementation of the resident medical insurance integration in China and the panel data of 278 cities at the prefecture level and above from 2006 to 2019,this paper uses the methods of time-varying DID and spatial DID to explore the effect and mechanism of the resident medical insurance integration on the urban-rural consumption gap.Results show that:1)The integration of resident medical insurance and the urban-rural consumption gap index show the characteristics of spatiotemporal coupling,which exhibits a gradual diffusion from coastal regions to inland areas and a gradual alleviation from inland areas to coastal regions respectively.The urban-rural consumption gap index is significantly lower in the Pearl River Delta,Yangtze River Delta,Shandong Peninsula which are the earlier policy pilot areas.2)The integration of resident medical insurance can significantly alleviate the urban-rural consumption gap,and there is a spatial spillover effect,which will slow down the urban-rural consumption gap in cities with similar economic development level,and aggravate the urban-rural consumption gap in geographically adjacent cities.3)By narrowing the urban-rural income gap and reducing precautionary savings,the integration of resident medical insurance alleviates the urban-rural consumption gap,and its effects on consumption inequality are heterogeneous in different economic agglomeration areas and cities with different levels of economic development.

关 键 词：居民医保一体化 城乡消费差距 渐进DID 空间DID 空间溢出效应 

分 类 号：F842.6[经济管理—保险]