自付医疗支出随着时间的推移会变成灾难性的支出,并对个体健康公平、生活福利造成影响。高自付医疗支出造成的灾难性支出是造成贫困的重要原因,也是发展中国家减贫的主要威胁。文章基于中国家庭动态跟踪调查(CFPS)数据,首先分析了家庭灾难性自付医疗支出(out-of-pocket,OOP)发生率、强度及其对贫困变动的效应,然后研究了灾难性自付医疗支出的决定因素及该种卫生筹资的亲贫性,最后对灾难性自付医疗支出的贫困退出时间进行了测算。结果显示:使用相对贫困线标准,自付医疗支出使贫困率上升6个百分点左右;家庭成员健康状况、经济状况等变量影响着灾难性自付医疗支出的发生概率,随着时间的推移,自付医疗支出这种卫生筹资方式的亲贫性在降低;当使用社会经济不平等指标调整后,灾难性自付医疗支出的贫困退出时间变动较小,而当使用纯粹不平等指标调整后,贫困退出时间变动很大;灾难性自付医疗支出发生率、强度、亲贫性及贫困退出时间在城乡之间、不同医保类型之间存在异质性。
灾难性自付医疗支出与贫困——来自中国的微观证据
摘要
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解垩. 灾难性自付医疗支出与贫困——来自中国的微观证据[J]. 上海财经大学学报, 2023, 25(3): 47-63.
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