城镇职工基本医疗保险下的医疗支出研究——不可忽视的持续性特征
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财经研究 2011 年 第 37 卷第 05 期, 页码：26 - 36
摘要
参考文献
摘要
文章利用2005-2007年江苏省昆山市城镇职工医疗保险数据,通过四部分模型研究基本医疗保险下的居民医疗支出持续性特征。研究发现,居民医疗支出持续性特征相当明显,如将其忽略会使其他变量存在估计偏误,其中对年龄的影响最大。持续性特征表现为:t-1期和t-2期的医疗支出对t期就诊或住院概率表现出不同的信号功能,t-1期的医疗支出对t期门诊或住院医疗支出的持续性效果是t-2期的6-7倍。对持续性特征的深入研究将为医疗保险制度改革提供实证依据。
关键词
②数据来源于《2007年劳动和社会保障事业发展统计公报》。
③根据《中国卫生统计年鉴2008》中相关数据计算得到。
④关于昆山市城镇职工基本医疗保险政策的详细介绍可参见《昆山市城镇职工基本医疗保险管理办法(2005.1.1起调整)》。
⑤参见Feenberg和Skinner(1994)和French和Jones(2004)。
[1]封进,李珍珍.中国农村医疗保障制度的补偿模式研究[J].经济研究,2009,(4):103-115.
[2]罗楚亮.健康风险与贫困人口的消费保险[J].卫生经济研究,2006,(1):36-38.
[3]罗楚亮.城镇居民健康差异与医疗支出行为[J].财经研究,2008,(10):63-75.
[4]饶克勤.中国城市居民医疗服务利用影响因素的研究——四步模型法的基本理论及其应用[J].中国卫生统计,2000,(2):70-73.
[5]叶春辉,封进,王晓润.收入、受教育水平和医疗消费:基于农户微观数据的分析[J].中国农村经济,2008,(8):16-24.
[6]Duan N,Manning W G,Morris C N,Newhouse J P.Acomparison of alternative modelsfor the demand for medical care[J].Journal of Business and Economic Statistics,1983,1(2):115-126.
[7]Duan N,Manning W G,Morris C N,Newhouse J P.Choosing between the sample-selection model and the multi-part model[J].Journal of Business and Economic Sta-tistics,1984,2(3):283-289.
[8]Eichner MJ,McClellan MB,Wise D A.Insurance or self-insurance?Variation,per-sistence,and individual health accounts[A].Wise D A.Inquires in the Economics ofAging[C].Chicago:University of Chicago Press,1998.
[9]Feenberg D R,Skinner J S.The risk and duration of catastrophic health care expendi-tures[J].Reviewof Economics and Statistics,1994,76(4):633-647.
[10]Feldstein M,Gruber J.A major risk approach to healthinsurance reform[R].NBERWorking Paper No 4852,1994.
[11]French E B,Jones J B.On the distribution and dynamics of health care costs[J].Journal of Applied Econometrics,2004,19(6):705-721.
[12]Lin P J,Biddle A K,Ganguly R,Kaufer D I,Maciejewski M L.The concentrationand persistence of health care expenditures and prescription drug expenditures in Medi-care beneficiaries with Alzhei mer disease and related dementias[J].Medical Care,2009,47(11):1174-1179.
[13]Manning W G,Newhouse J P,Duan N,Keeler E B,Leibowitz A,Marquis M S.Healthinsurance and the demand for medical care:Evidence froma randomized experi-ment[J].American Economic Review,1987,77(3):251-277.
[14]Mocan N H,Tekin E,Zax J S.The demand for medical care in urban China[J].World Development,2004,32(2):289-304.
[15]Rettenmaier AJ,Wang Z.Persistencein Medicare rei mbursements and personal medi-cal accounts[J].Journal of Health Economics,2006,25(1):39-57.
[16]Shenkman E,Knapp C,Sappington D,Vogel B,Schatz D.Persistence of high healthcare expenditures among childrenin Medicaid[J].Medical Care Research and Review,2007,64(3):304-330.
③根据《中国卫生统计年鉴2008》中相关数据计算得到。
④关于昆山市城镇职工基本医疗保险政策的详细介绍可参见《昆山市城镇职工基本医疗保险管理办法(2005.1.1起调整)》。
⑤参见Feenberg和Skinner(1994)和French和Jones(2004)。
[1]封进,李珍珍.中国农村医疗保障制度的补偿模式研究[J].经济研究,2009,(4):103-115.
[2]罗楚亮.健康风险与贫困人口的消费保险[J].卫生经济研究,2006,(1):36-38.
[3]罗楚亮.城镇居民健康差异与医疗支出行为[J].财经研究,2008,(10):63-75.
[4]饶克勤.中国城市居民医疗服务利用影响因素的研究——四步模型法的基本理论及其应用[J].中国卫生统计,2000,(2):70-73.
[5]叶春辉,封进,王晓润.收入、受教育水平和医疗消费:基于农户微观数据的分析[J].中国农村经济,2008,(8):16-24.
[6]Duan N,Manning W G,Morris C N,Newhouse J P.Acomparison of alternative modelsfor the demand for medical care[J].Journal of Business and Economic Statistics,1983,1(2):115-126.
[7]Duan N,Manning W G,Morris C N,Newhouse J P.Choosing between the sample-selection model and the multi-part model[J].Journal of Business and Economic Sta-tistics,1984,2(3):283-289.
[8]Eichner MJ,McClellan MB,Wise D A.Insurance or self-insurance?Variation,per-sistence,and individual health accounts[A].Wise D A.Inquires in the Economics ofAging[C].Chicago:University of Chicago Press,1998.
[9]Feenberg D R,Skinner J S.The risk and duration of catastrophic health care expendi-tures[J].Reviewof Economics and Statistics,1994,76(4):633-647.
[10]Feldstein M,Gruber J.A major risk approach to healthinsurance reform[R].NBERWorking Paper No 4852,1994.
[11]French E B,Jones J B.On the distribution and dynamics of health care costs[J].Journal of Applied Econometrics,2004,19(6):705-721.
[12]Lin P J,Biddle A K,Ganguly R,Kaufer D I,Maciejewski M L.The concentrationand persistence of health care expenditures and prescription drug expenditures in Medi-care beneficiaries with Alzhei mer disease and related dementias[J].Medical Care,2009,47(11):1174-1179.
[13]Manning W G,Newhouse J P,Duan N,Keeler E B,Leibowitz A,Marquis M S.Healthinsurance and the demand for medical care:Evidence froma randomized experi-ment[J].American Economic Review,1987,77(3):251-277.
[14]Mocan N H,Tekin E,Zax J S.The demand for medical care in urban China[J].World Development,2004,32(2):289-304.
[15]Rettenmaier AJ,Wang Z.Persistencein Medicare rei mbursements and personal medi-cal accounts[J].Journal of Health Economics,2006,25(1):39-57.
[16]Shenkman E,Knapp C,Sappington D,Vogel B,Schatz D.Persistence of high healthcare expenditures among childrenin Medicaid[J].Medical Care Research and Review,2007,64(3):304-330.
引用本文
许玲丽, 龚关, 王红梅. 城镇职工基本医疗保险下的医疗支出研究——不可忽视的持续性特征[J]. 财经研究, 2011, 37(5): 26–36.
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