医疗保险异地就医直接结算对居民健康的影响研究  

The Effect of Direct Settlement of Medical Insurance for Nonlocal Medical Treatment on Residents' Health

作　　者：高娜娜 胡宏兵[2] 刘奥龙[1] Gao Nana;Hu Hongbing;Liu Aolong(School of Economics,Henan University,Kaifeng 475004,China;School of Finance,Zhongnan University of Economics and Law,Wuhan 430073,China)

机构地区：[1]河南大学经济学院,河南开封475004 [2]中南财经政法大学金融学院,湖北武汉430073

出　　处：《财经研究》2023年第6期94-108,共15页Journal of Finance and Economics

基　　金：国家社会科学基金一般项目(22BJY217)。

摘　　要：持续推进医保权益和医疗服务的公平性和可及性是推进“健康中国”战略实施和实现共同富裕的内在要求。文章采用CHARLS数据和双重差分模型检验了医疗保险异地就医直接结算对居民健康的影响。研究发现,异地就医直接结算显著提升了居民的自评健康。但该政策的健康效应对农村居民、新农合参保居民、低教育程度居民和低收入水平居民的影响更显著,其提升了弱势群体的健康水平,缩小了不同群体之间的健康差距。机制分析表明,异地就医直接结算通过提升参保居民医疗资源利用、降低医疗费用负担、释放医疗服务需求、增加家庭消费支出和改变家庭消费结构来影响其健康。为了实现更高水平的全民健康,需要继续深化医疗保障制度改革,加大基本医疗保险统筹力度,稳步提高医疗保险待遇水平,并且推动医疗健康资源向弱势群体倾斜。Continuously promoting the equity and accessibility of medical insurance rights and medical services is an inherent requirement for promoting the implementation of the Healthy China Strategy and achieving common prosperity.In order to solve the problem of difficulty in reimbursement of medical expenses for nonlocal medical treatment,since the New Medical Reform in 2009,China has begun to promote the policy of direct settlement of medical insurance for nonlocal medical treatment.However,at present,there is relatively little literature on the evaluation of the effect of direct settlement policy.Based on the quasi-natural experiment of the direct settlement for intra-provincial medical treatment,this paper uses CHARLS data and DID model to empirically evaluate the health effect of direct settlement of medical insurance for nonlocal medical treatment,analyzes whether the policy is more beneficial to vulnerable groups,and discusses the mechanism of the policy to improve residents' health level from the perspectives of medical treatment behavior,medical expenses and family consumption upgrading.The results show that:First,the policy has a significant effect on the health of insured residents.Second,the policy has a more significant impact on the health of rural residents,new rural cooperative medical insurance insured residents,low-education residents and low-income residents,and it improves the health level of vulnerable groups.Third,the policy affects the health of insured residents by improving the utilization of medical resources,reducing the burden of medical expenses,releasing the demand for medical services,increasing household consumption expenditure and changing the household consumption structure.Therefore,it is necessary to continue to deepen the reform of the medical security system,improve the overall pooling level of basic medical insurance,steadily improve the level of medical insurance benefits,and promote medical and health resources to favor vulnerable groups.The possible marginal contributions of thi

关 键 词：共同富裕 医疗保险基本公共服务均等化 异地就医直接结算 健康 

分 类 号：F842.684[经济管理—保险] R197.1[医药卫生—卫生事业管理]