Objective:Analyze the impact of provincial overall planning of urban-rural resident medical insurance on medical expenses,in order to evaluate the policy effectiveness of provincial overall planning of residents' medical insurance. Methods:Based on the five period panel data of China Family Panel Studies (CFPS) from 2012 to 2020,a Difference in Differences (DID) Model was used to test the impact and mechanism of the provincial overall planning of urban-rural resident medical insurance on medical expenses. Results:The provincial overall planning policy of basic medical insurance for residents significantly promotes the growth of total medical expenses,and various medical expenses classified by diagnosis and treatment methods (hospitalization and outpatient expenses) and payment channels (out of pocket expenses,reimbursement expenses) also show significant increases,especially in reimbursable expenses. The analysis of intermediary and mediation effects shows that the implementation of provincial overall planning policies will affect the various medical expenses of insured persons through their healthcare-seeking behavior. Individual health levels have a significant positive moderating effect. Heterogeneity analysis found that the positive impact of provincial overall planning on medical expenses is more significant among young people,rural insured groups,and insured groups with chronic diseases. Conclusions and suggestions:Considering the differences in medical resource allocation and medical security governance capabilities in different coordinated regions,it is necessary to promote the provincial overall planning of residents' medical insurance according to local conditions. Establish a unified medical insurance policy. Strengthen the integration of cross regional medical resources and promote the tilt of high-quality medical resources towards the grassroots level.
关键词
省级统筹/城乡居民医保/医疗费用/就医行为
Key words
Provincial overall planning/Basic medical insurance for urban and rural residents/Medical expenses/Healthcare-seeking behavior