“健康中国”背景下医疗保险对中老年人健康的影响研究  

Study on the impact of health insurance on the health of middle-aged and older adults in the context of“Healthy China”

作　　者：陈雅静 杨希 赵伟华[3] CHEN Yajing;YANG Xi;ZHAO Weihua(School of Public Administration,Central China Normal University,Wuhan Hubei 430079,China;School of Management,Hubei University of Chinese Medicine,Wuhan Hubei 430065,China;Zhongnan Hospital of Wuhan University,Wuhan Hubei 430071,China)

机构地区：[1]华中师范大学公共管理学院,湖北武汉430079 [2]湖北中医药大学管理学院,湖北武汉430065 [3]武汉大学中南医院,湖北武汉430071

出　　处：《卫生软科学》2025年第4期69-75,共7页Soft Science of Health

基　　金：湖北省高等学校哲学社会科学研究重大项目(22ZD090)。

摘　　要：[目的]探讨医疗保险对中老年人健康的影响。[方法]基于2013年、2015年、2018年3期中国健康与养老追踪调查(CHARLS)混合截面数据,采用固定效应模型分析医疗保险对中老年人身心健康的影响,并进行机制检验和异质性分析。[结果]医疗保险对中老年人身体健康有显著影响(β=-0.509,P<0.05),在性别、年龄、城乡以及消费水平上呈现差异;医疗保险对心理健康的影响不显著(β=-0.168,P>0.1),仅存在年龄差异。机制分析表明,医疗保险通过改变就医行为,增加医疗服务利用,促进中老年人身体健康。[结论]医疗保险对就医行为的影响促进了中老年人身体健康,且存在群体异质性;要加强对中老年人身心健康的重视,将更多心理健康服务项目纳入医保报销范围;加快门诊统筹,提高门诊报销比例;完善医保筹资机制,提高老年人医保待遇水平。Objective To explore the impact of health insurance on the health of middle-aged and older adults.Methods Based on the mixed cross-sectional data of China Health and Retirement Longitudinal Study(CHARLS)in 2013,2015 and 2018,the Fixed Effects Model was used to analyze the impact of health insurance on the physical and mental health of middle-aged and older adults,and the mechanism validation and heterogeneity analysis were conducted.Results Health insurance had a significant impact on the physical health of middle-aged and older adults(β=-0.509,P<0.05),showing differences in gender,age,urban and rural areas as well as the level of consumption,but had no significant impact on mental health(β=-0.168,P>0.1),with only age differences.Mechanism analysis showed that health insurance changed behaviors of seeking medical care and increased the utilization of medical services to promote the physical health of middle-aged and older adults.Conclusions Health insurance promotes the physical health of middle-aged and older adults by changing their behaviors of seeking medical care,and there is group heterogeneity.It is necessary to pay more attention to the physical and mental health of middle-aged and older adults,and include more mental health services into the scope of health insurance reimbursement;to accelerate the risk pooling of outpatient services and increase the ratio of reimbursement for outpatient services;and to improve medical insurance financing mechanisms,and raise the level of medical insurance benefits for older adults.

关 键 词：医疗保险 中老年人 身心健康 机制分析 

分 类 号：R19[医药卫生—卫生事业管理] F840.684[医药卫生—公共卫生与预防医学]