中国农村老年人的医疗消费与健康状况:新农合带来的变化

Medical Consumption and Health Status of Rural Elderly in China:The Impact of the New Cooperative Medical Scheme

本文采用中国健康和营养调查(CHNS)2000年和2006年数据,构建老年人医疗消费两部模型,采用D ID-M atch ing半参数分析方法控制模型的内生性问题,实证分析了新型农村合作医疗对老年人医疗服务消费和健康状况的影响。研究结果表明,新农合显著地降低了老年人自付医疗支出,促进了老年人健康状况的自我评价,也提高了老年人对自身慢性病(高血压)的知晓度;本文也证明了新农合对老年人健康状况的改善是通过增进老年人预防性卫生保健服务,而非促进医疗服务的消费而产生的。因此,进一步完善新农合在加强农村老年人预防保健服务的可及性和可得性中的作用,对促进老年人健康状况具有重要意义。

This paper analyzed the impact of the New Cooperative Medical Scheme on the medical consumption and health status of rural elderly in China by setting up a two-part model on the basis of 2000 and 2006 database of The China Health and Nutrition Survey and using the DID-Matching model to control the endogenous problems.The result showed that the NCMS significantly reduced the elderly out-of pocket payment,promoted the elderly self-evaluation of health status,and increased their awareness of their chronic disease（hypertension）.It also proved that the NCMS could improve the elderly health by enhancing the elderly preventative health care services instead of by raising medical service consumption.Therefore,it is significant to perfect the role of the NCMS in strengthening the rural elderly accessibility to and the availability of preventative health care services.