城乡居民医保整合对农村中老年人心理健康的影响  

Study on the Impact of Urban-Rural Health Insurance Integration on the Mental Health of Middle-Aged and 01-der Adults in Rural Areas

作　　者：黄德荣 王桂杰[3] 王健 付英杰[1,2] 方慧玲 李超凡 赵若楠 刘美[1,2] Huang Derong(Centre for Health Management and Policy Research,School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan,P.R.China)

机构地区：[1]山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心,山东济南250012 [2]国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学) [3]博兴县疾病预防控制中心

出　　处：《中国卫生事业管理》2024年第5期518-522,共5页Chinese Health Service Management

基　　金：国家自然科学基金面上项目“基于DRM法主观幸福感的测量及影响因素关系模型构建-以农村居民为例”(71273156);国家自然科学基金青年基金项目“普惠型医疗保险的选择偏好与助推机制研究”(72204146);山东省卫健委资助项目“山东省建立健全现代医院管理制度试点工作评估研究”(SK210655);山东大学齐鲁医学院本科教改项目“新时代公卫专业学生职业素养提升研究”(qlyxjy-202126)。

摘　　要：目的:分析城乡居民医保整合对农村中老年人心理健康的影响及作用机制,为政策制定提供参考。方法:使用中国健康与养老追踪调查(China Health and Retirement Longitudinal Study, CHARLS)2011年、2013年、2015年和2018年四期面板数据,运用多期双重差分法评估城乡居民医保整合对农村中老年人心理健康的影响,同时分析性别、慢性病和地区异质性,并进一步检验功能受限和劳动参与的中介效应。结果:城乡居民医保整合可以改善农村中老年人心理健康(P<0.01),对男性、西部地区农村中老年人有更显著的作用,但是在是否患有慢性病方面没有存在差异。城乡居民医保整合可能通过功能受限、劳动参与对农村中老年人的心理健康产生影响。结论:城乡居民医保政策可能对农村中老年人的心理健康产生影响,政府应关注城乡居民医保政策在心理健康方面的效益,在政策制定中充分考虑不同特征农村中老年人的差异,提高统筹层次,强化区域间协同。Objective To analyze the effect and mechanism of medical insurance integration of urban and rural residents on the mental health of middle-aged and older adults in rural areas,and provide scientific basis for policy making.Methods Data of the China Health and Retirement Longitudinal Study(CHARLS 2011,2013,2015 and 2018)were used to evaluate the effect of urban-rural health insurance integration on the mental health of middle-aged and older adults in rural areas by using the multi-period differences-in-differences method.And the heterogeneity of gender,chronic diseases and region were analyzed to further examine the mediating effects of functional limitations and labor participation.Results Urban-rural health insurance integration can improve the mental health of middle-aged and older adults in rural areas(P<0.01),especially for males and middle-aged and older adults in the western region,while there was no difference in the impact in terms of whether having chronic diseases.Urban-rural health insurance integration has an impact on mental health of middle-aged and older adults in rural areas through functional limitations and labor participation.Conclusion Urban-rural health insurance integration policy may have an impact on the mental health of middle-aged and older adults in rural areas.The government should pay attention to the effect of urban-rural health insurance integration on the mental health of middle-aged and older adults in rural areas,fully consider the differences among middle-aged and older adults in rural areas with different characteristics in policy formulation,improve the overall planning level,and strengthen regional coordination.

关 键 词：城乡居民医保整合 农村中老年人 心理健康 双重差分法 

分 类 号：R197.1[医药卫生—卫生事业管理] C913.6[医药卫生—公共卫生与预防医学]