医疗保险对老年人医疗支出与健康的影响
财经研究 2014 年 第 40 卷第 12 期, 页码:65 - 75
摘要
参考文献
摘要
文章根据中国老年人健康影响因素跟踪调查(CLHLS)2008—2011年两期面板数据,利用Heckman模型、两部模型、面板Logit模型和排序模型等方法,在系统控制老年人医疗支出的内生性和样本选择偏误的基础上,实证检验了我国医疗保险对老年人医疗服务需求与健康的影响。研究发现:(1)医疗保险促进了老年人的医疗服务利用,增加了老年人的医疗费用总支出,提高了老年人的及时就医概率;(2)医疗保险虽然显著改善了老年人的医疗服务利用和健康状况,但是医疗保险对老年人的医疗服务利用尚存在显著的城乡和地区差异;(3)医疗保险对老年人的健康状况有明显的促进作用;(4)医疗保险显著降低了老年人的家庭医疗负担。
[1]白重恩,李宏彬,吴斌珍.医疗保险与消费:来自新型农村合作医疗的证据[J].经济研究,2012,(2):41-53.
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[4]王新军,郑超.老年人健康与长期护理的实证分析[J].山东大学学报(哲学社会科学版),2014,(3):30-41.
[5]臧文斌,刘国恩,徐菲,等.中国城镇居民基本医疗保险对家庭消费的影响[J].经济研究,2012,(7):75-85.
[6]臧文斌,赵绍阳,刘国恩.城镇基本医疗保险中逆向选择的检验[J].经济学(季刊),2013,(1):47-70.
[7]赵邵阳,臧文斌,傅十和,等.强制医保制度下无保险人群的健康状况研究[J].经济研究,2013,(7):118-131.
[8]赵忠,侯振刚.我国城镇居民的健康需求与Grossman模型——来自截面数据的证据[J].经济研究,2005,(10):79-90.
[9]Bolhaar J,Lindeboom M,van der Klaauw B.A dynamic analysis of the demand for health insurance and health care[J].European Economic Review,2012,56(3-4):669-690.
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[12]Chen Y,Jin G Z.Does health insurance coverage lead to better health and educational outcomes?Evidence from rural China[J].Journal of Health Economics,2012,31(1):1-14.
[13]Chou S Y,Grossman M,Liu J T.The impact of national health insurance on birth outcomes:a natural experiment in Taiwan[J].NBER Working Paper No.16811,2011.
[14]Finkelstein A,McKnight R.What did Medicare do?The initial impact of medicare on mortality and out of pocket medical spending[J].Journal of Public Economics,2008,92(7):1644-1668.
[15]Finkelstein A,Taubman S,Wright B,et al.The Oregon health insurance experiment:Evidence from the first year[J].The Quarterly Journal of Economics,2012,27(3):1057-1106.
[16]Gruber J.Massachusetts health care reform:The view from one year out[J].Risk Management and Insurance Review,2008,11(1):51-63.
[17]Hackmann M B,Jonathan T K,Amanda E K.Health reform,health insurance,and selection:Estimating selection into health insurance using the massachusetts Health Reform[J].American Economic Review,2012,102(3):498-501.
[18]Keng S,Sheu S.The effect of national health insurance on mortality and the SES-health gradient:Evidence from the elderly in Taiwan[J].Health Economics,2013,22(1):52-72.
[19]Mwalili S M,Lesaffre E,Declerck D.The zero-inflated negative binomial regression model with correction for misclassification:An example in caries research[J].Statistical Methods in Medical Research,2008,17(2):123-139.
[20]Mellor J,Milyo J.Income inequality and health status in the United States:Evidence from the current population survey[J].Journal of Human Resource,2002,37(3):510-539.
[21]Sun X,Jackson S,Carmichael G,et al.Catastrophic medical payment and financial protection in rural China:Evidence from the new cooperative medical scheme In Shandong province[J].Health Economics,2009,18(1):103-119.
[22]Wagstaff A,Lindelow M,Gao J,et al.Extending health insurance to the rural population:An impact evaluation of China’s new cooperative medical scheme[J].Journal of Health Economics,2009,28(1):1-19.
[23]Worthington A C.Frontier efficiency measurement in health care:A review of empirical techniques and selected applications[J].Medical Care Research and Review,2004,61(2):135-170.
1数据来源于《中国老龄事业发展报告(2013)》。
1这一指标是基于CLHLS问卷调查中“您觉得现在您的身体健康状况怎么样”的回答。
[2]胡宏伟,刘国恩.城镇居民医疗保险对国民健康的影响效应与机制[J].南方经济,2012,(10):186-199.
[3]黄枫,甘犁.过度需求还是有效需求?——城镇老人健康与医疗保险的实证分析[J],经济研究,2010,(6):105-119.
[4]王新军,郑超.老年人健康与长期护理的实证分析[J].山东大学学报(哲学社会科学版),2014,(3):30-41.
[5]臧文斌,刘国恩,徐菲,等.中国城镇居民基本医疗保险对家庭消费的影响[J].经济研究,2012,(7):75-85.
[6]臧文斌,赵绍阳,刘国恩.城镇基本医疗保险中逆向选择的检验[J].经济学(季刊),2013,(1):47-70.
[7]赵邵阳,臧文斌,傅十和,等.强制医保制度下无保险人群的健康状况研究[J].经济研究,2013,(7):118-131.
[8]赵忠,侯振刚.我国城镇居民的健康需求与Grossman模型——来自截面数据的证据[J].经济研究,2005,(10):79-90.
[9]Bolhaar J,Lindeboom M,van der Klaauw B.A dynamic analysis of the demand for health insurance and health care[J].European Economic Review,2012,56(3-4):669-690.
[10]Brown J,R,Finkelstein A.The interaction of public and private insurance:Medicaid and the long-term care insurance market[J].American Economic Review,2008,98(3):1083-1102.
[11]Card D,Dobkin C,Maestas N.The impact of nearly universal insurance coverage on health care utilization:Evidence from medicare[J].American Economic Review,2008,98(5):2242-2258.
[12]Chen Y,Jin G Z.Does health insurance coverage lead to better health and educational outcomes?Evidence from rural China[J].Journal of Health Economics,2012,31(1):1-14.
[13]Chou S Y,Grossman M,Liu J T.The impact of national health insurance on birth outcomes:a natural experiment in Taiwan[J].NBER Working Paper No.16811,2011.
[14]Finkelstein A,McKnight R.What did Medicare do?The initial impact of medicare on mortality and out of pocket medical spending[J].Journal of Public Economics,2008,92(7):1644-1668.
[15]Finkelstein A,Taubman S,Wright B,et al.The Oregon health insurance experiment:Evidence from the first year[J].The Quarterly Journal of Economics,2012,27(3):1057-1106.
[16]Gruber J.Massachusetts health care reform:The view from one year out[J].Risk Management and Insurance Review,2008,11(1):51-63.
[17]Hackmann M B,Jonathan T K,Amanda E K.Health reform,health insurance,and selection:Estimating selection into health insurance using the massachusetts Health Reform[J].American Economic Review,2012,102(3):498-501.
[18]Keng S,Sheu S.The effect of national health insurance on mortality and the SES-health gradient:Evidence from the elderly in Taiwan[J].Health Economics,2013,22(1):52-72.
[19]Mwalili S M,Lesaffre E,Declerck D.The zero-inflated negative binomial regression model with correction for misclassification:An example in caries research[J].Statistical Methods in Medical Research,2008,17(2):123-139.
[20]Mellor J,Milyo J.Income inequality and health status in the United States:Evidence from the current population survey[J].Journal of Human Resource,2002,37(3):510-539.
[21]Sun X,Jackson S,Carmichael G,et al.Catastrophic medical payment and financial protection in rural China:Evidence from the new cooperative medical scheme In Shandong province[J].Health Economics,2009,18(1):103-119.
[22]Wagstaff A,Lindelow M,Gao J,et al.Extending health insurance to the rural population:An impact evaluation of China’s new cooperative medical scheme[J].Journal of Health Economics,2009,28(1):1-19.
[23]Worthington A C.Frontier efficiency measurement in health care:A review of empirical techniques and selected applications[J].Medical Care Research and Review,2004,61(2):135-170.
1数据来源于《中国老龄事业发展报告(2013)》。
1这一指标是基于CLHLS问卷调查中“您觉得现在您的身体健康状况怎么样”的回答。
引用本文
王新军, 郑超. 医疗保险对老年人医疗支出与健康的影响[J]. 财经研究, 2014, 40(12): 65–75.
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