社会医疗保险与我国医疗服务利用的公平性研究

Analysis on Social Medical Insurance and the Equity of Chinese Medical Service Utilization

目的:考察我国社会医疗保险对医疗公平性的影响。方法:利用中国健康与营养调查数据,基于集中指数进行研究。结果:(1)我国医疗服务利用的集中指数为正,但其取值和显著性随时间推移而下降;(2)新型农村合作医疗对集中指数的贡献总体为负,且绝对值呈扩大趋势;(3)城镇居民基本医疗保险和城镇职工基本医疗保险对集中指数的贡献为正,但前者的影响有限。结论:我国医疗服务利用的公平性逐渐改善;社会医疗保险对医疗公平性的影响存在差异,这表现为新型农村合作医疗成为提高公平性的重要社会医疗保障制度,而城镇职工基本医疗保险在较大程度上降低了医疗公平,城镇居民基本医疗保险的影响则相对较小。

Objective:To investigate the effects of social medical insurances on the equity of medical treatment.Methods:Basedon the concentration index, the data of China health and nutrition was applied to analyze.Results:(1) The concentration indexes ofmedical service utilization were generally positive, but their values and significances declined over time;(2) new cooperate medical in-surance negatively contributed to concentration index, and the absolute value was expanding;(3) basic medical insurance for urban res-idents and basic medical insurance for urban employees positively contributed to concentration index, but the influences of the formerwere trivial.Conclusion:Chinese medical service utilization tended to be more equitable; social medical insurances exerted distinctinfluences on the equity of medical service utilization; new cooperate medical insurance helped to enhance health equity, while basicmedical insurance for urban employees caused medical utilization to be more unequable.