通讯作者: 李寒旋, 15927416370@163.com

DOI：10.12201/bmr.202412.00007

Health Inequalities among Internal Migrants in China from the Perspective of Medical Insurance: Theoretical Framework, Measurement and Mechanism Analysis

• 摘要：目的：构建医疗保险视角下流动人口健康不平等框架并分析我国流动人口健康不平等。方法：以2017和2018年中国流动人口动态监测调查为数据源，基于Dover健康公平测量框架，通过集中指数及其分解探究医保视角下流动人口健康不平等现状及生成机制。结果：收入水平较高的流动人口，在医疗服务利用、医保服务利用和健康结果方面的表现更优；医疗保险是医疗和医保服务利用不平等的重要贡献因素，但对健康结果不平等的贡献度较低。结论：医疗保险对流动人口健康不平等的影响呈多层次特征，医疗保险制度的社会分层效应和健康社会效应差异是导致不平等的内在机制。建议围绕筹资、待遇和经办等关键环节，多措并举提升流动人口医疗保障的公平性，缩小流动人口医疗、医保服务利用及健康结果不平等。

  关键词： 流动人口；医疗保险；健康不平等；集中指数; ; ; 

   

  Abstract: Objective: Constructing a framework to assess health inequality among migrants through the perspective of medical insurance, this study examines the inequalities and underlying mechanisms affecting Chinas internal migrants. Methods: Data were extracted from the 2017 and 2018 China Migrants Dynamic Survey datasets. The health equity measurement framework developed by Dover, the concentration index and its decomposition method were used to analyse the characteristics and mechanisms of health inequalities among migrants. Results: The results showed that the migrants with higher income levels performed better on medical services utilization, medical insurance services utilization, and health outcomes. Medical insurance contributed vitally to the inequalities in medical services utilization and medical insurance services utilization, but little to the health outcomes. Conclusion: The impact of medical insurance on health inequalities among migrants showed multi-level characteristics. The social stratification effect and the differences in health social effects of medical insurance are the internal mechanisms that lead to health inequalities. It is suggested to enhance the equality of medical security of migrants through financing, benefits, and administration to reduce inequalities in the medical services utilization, medical insurance services utilization, and health outcomes among Chinas internal migrants.

  Key words: Migrants; Medical insurance; Health inequalities; Concentration index

  提交时间：2024-12-02

  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	2024-07-16	bmr.202412.00007V1	下载

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