通讯作者: 宁满秀, njauyeying@163.com

DOI：10.12201/bmr.202207.00035

Does The policy of Integrated Medical Insurance System (IMIS) Alleviate The Medical Burden of the Middle and Old Aged People in Rural Areas? Empirical Analysis Based on The CHARLS Data

• 摘要：使用中国健康与养老追踪调查数据(CHARLS),基于双重差分的分析框架采用Heckman样本选择模型,实证评估了城乡医保整合政策对农村中老年人医疗费用负担的影响。研究发现：城乡医保整合政策有助于减轻农村中老年人医疗费用负担,并且采取“一制多档”整合模式比“城乡一档”整合模式的效果更好。异质性分析表明：在年龄分组上,城乡医保整合政策及“一制多档”的整合模式有利于降低65岁以上高龄老年群体的医疗负担,但对45-55岁的低龄老人影响不显著；在收入分组上,实施城乡医保整合政策对于减少中等收入群体医疗负担的效果好于低收入和高收入群体,但采用“城乡一档”的整合模式对低收入群体医疗负担减少效果不显著。总体而言,实施城乡医保整合政策减轻了农村中老年人医疗费用负担,对缓解城乡医疗保障差距有促进作用,政策实施达到预期效果。

  关键词： 城乡医保整合; 医疗负担; Heckman模型

   

  Abstract: Based on the quasi-natural experiment Integrated Medical Insurance System(IMIS), this paper empirically verifies the effect of IMIS on the medical burden of middle-aged and elderly in China, by employing the data set of China Health and Retirement Longitudinal Study(CHARLS)and using the Heckman model under Difference-in-difference (DID) method. The results illustrate that, compared with those non-integrated areas, the policy of IMIS helps to reduce the burden of medical expenses of middle-aged and elderly patients, and the burden reduction effect of mode “single system, multi-standard” is better than the model of “single system, single-standard”. Based on the heterogeneity analysis among groups by age, it is showed that the “single system, multi-standard” model exerts significant positive to reducing the medical burden of the elderly over 65 years old, but no significant impact on the group of age in 45-55. Based on the heterogeneity analysis among groups by income, the results show that the IMIS policy is better for middle-income groups than low-income and high-income groups in reducing the medical burden, However, the integration model of “single system, single-standard” . In a word, the IMIS has achieved the expected effect that reducing the medical burden of rural middle-aged and elderly people and narrowing the gap between urban and rural medical security.

  Key words: IMIS; medical burden; Heckman model

  提交时间：2022-07-15

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2022-04-05	bmr.202207.00035V1	下载

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