首页|医保制度整合背景下城乡居民住院服务利用差异的影响因素研究

医保制度整合背景下城乡居民住院服务利用差异的影响因素研究

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目的 测量医保制度整合后城乡居民住院服务利用差异值，分析城乡居民住院服务利用差异的主要影响因素及贡献程度。方法 利用2018年中国健康与养老追踪数据，采用Oaxaca-Blinder分解法辅以Heckman两步法对城乡居民住院服务利用差异进行度量和分解。结果 城乡居民住院服务利用的差异可分为禀赋效应和系数效应，其中禀赋效应占比53。2％，系数效应占比46。8％。禀赋效应中经济因素和医疗保险制度是造成城乡居民住院服务利用差异的主要因素，贡献率分别为26。6％和28。4％，系数效应即因城乡属性不同导致的城乡住院服务利用差异贡献率为46。8％。结论 应在顶层设计和统筹方面进一步完善医疗保险制度，制定有利于农村经济弱势群体的补偿政策，充分发挥政府和市场的协同配合作用。
Study on the Influencing Factors of the Difference of Hospitalization Service Utilization between Urban and Rural Residents under the Background of Medical Insurance System Integration
Objective To measure the value of the difference in hospitalization service utilization between urban and rural residents after medical insurance system integration,and to analyze its main influencing factors and contri-butions.Methods The Oaxaca-Blinder decomposition method supplemented by the Heckman two-step estimation was used to measure and decompose the difference in hospitalization service utilization between urban and rural resi-dents using the data from China Health and Retirement Longitudinal Study in 2018.Results The differences in hos-pitalization service utilization between urban and rural residents could be divided into the endowment effect and the coefficient effect,with the endowment effect accounting for 53.2％and the coefficient effect accounting for 46.8％.The economic factors and medical insurance system among the endowment effect were the main factors causing the difference in hospitalization service utilization between urban and rural residents,with the contribution rate divided into 26.6％and 28.4％.Coefficient effect,that is,the difference contribution rate of urban and rural inpatient service utilization caused by different urban and rural attributes was 46.8％.Conclusion The medical insurance system should be further improved in terms of top-level design and coordination,compensation policies favorable to economi-cally disadvantaged groups in rural areas should be formulated,and the synergy between the government and the market should be given full play.

Medical insurance system integrationUrban-rural differencesHospitalization service utilizationHospitalization expenses

陈东权、程怀志、郭斌、商杰森、张婷婷、高凌霄、田若童

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哈尔滨医科大学大庆校区人文社会科学系,黑龙江 大庆,163319

医保制度整合 城乡差异 住院服务利用 住院费用支出

国家自然科学基金青年项目黑龙江省省属高等学校基本科研业务费基础研究项目大庆市哲学社会科学规划项目黑龙江省自然科学基金联合引导项目

71704039JFCX202101DSGB2022136LH2023G006

2024

10.3969/j.issn.1673-5625.2024.05.024

中国社会医学杂志
华中科技大学同济医学院

中国社会医学杂志

CSTPCD
影响因子：1.193
ISSN：1673-5625
年,卷(期)：2024.41(5)