参保机会、保障水平与医疗服务利用均等化——基于广东省A市的地区差异分析
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财经研究 2013 年 第 39 卷第 07 期, 页码：97 - 110
摘要
参考文献
摘要
文章基于两部模型,利用从广东省A市城镇职工基本医疗保险信息管理系统中提取的微观数据,考察了参保机会及保障水平对该市三个地区参保人医疗服务利用及其均等化的影响。主要结论是:参保机会均等总体上能促进地区间医疗服务利用均等化,但无法从根本上解决亲富人的医疗服务利用不公平问题;实际报销比例对频率决策阶段的医疗服务利用有显著的正向影响,意味着很可能存在过度医疗,而起付标准对参保人理性就医的约束力有限;特殊病种门诊医疗服务利用在三个地区之间基本实现了均等化,但触发决策阶段的住院医疗服务利用存在地区间不均等,地区间收入水平和住院医疗服务利用率的双重差异是引起这种不均等的主要原因。
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[2]申曙光,侯小娟.我国社会医疗保险制度的“碎片化”与制度整合目标[J].广东社会科学,2012,(3):19-25.
[3]解垩.与收入相关的健康及医疗服务利用不平等研究[J].经济研究,2009,(2):92-105.
[4]Gerdtham U G.Equity in health care utilization:Further tests based on hurdle modelsand Swedish micro data[J].Health Economics,1997,6(3):303-319.
[5]Kakwani N,Wagstaff A,Van Doorslaer E.Socioeconomic inequalities in health:Meas-urement,computation,and statistical inference[J].Journal of Econometrics,1997,77(1):87-103.
[6]Liu G G,Zhao Z.Urban employee health insurance reform and the impact on out-of-pocket payment in China[J].The International Journal of Health Planning and Manage-ment,2006,21(3):211-228.
[7]Manning W G,Newhouse J P,Duan N,et al.Health insurance and the demand for med-ical care:Evidence from a randomized experiment[J].The American Economic Review,1987,77(3):251-277.
[8]McCullagh P,Nedlder J A.Generalised linear models[M].London:Chapman&Hall,1983...
[9]Mullahy J.Specification and testing of some modified count data models[J].Journal ofEconometrics,1986,33(3):341-365.
[10]Van Doorslaer E,Wagstaff A,Van Der Burg H,et al.Equity in the delivery of healthcare in Europe and the US[J].Journal of Health Economics,2000,19(5):553-583.
[11]Van Doorslaer E,Koolman X,Jones A M.Explaining income-related inequalities indoctor utilisation in Europe[J].Health Economics,2004,13(7):629-647.
[12]Wagstaff A,Van Doorslaer E,Watanabe N.On decomposing the causes of health sec-tor inequalities with an application to malnutrition inequalities in Vietnam[J].Journal ofEconometrics,2003,112(1):207-223.
引用本文
瞿婷婷, 申曙光. 参保机会、保障水平与医疗服务利用均等化——基于广东省A市的地区差异分析[J]. 财经研究, 2013, 39(7): 97–110.
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