应用匹配倍差法评估城镇居民医疗保险对医疗服务利用的影响

Evaluating the Effects of Urban Resident Basic Medical Insurance on Medical Service Utilization Based on Matching DID Model

目的:评估城镇居民医疗保险对居民医疗服务利用的影响。方法:利用2006年和2009年中国健康和营养调查的面板数据,采用匹配倍差法,以2009年有城镇居民保险居民为干预组,无城镇居民保险居民为对照组,分别构建就诊概率模型和医疗支出模型。结果:在实施初期,城镇居民保险一定程度上促进了医疗服务利用,但整体影响水平还比较低,对住院服务利用的促进作用较明显,但对门诊服务作用有限。结论:促进门诊服务利用和加大补偿力度是未来城镇居民保险制度完善的优先选择,有利于充分发挥制度作用。

Objective： To identify the impact of Urban Resident Basic Medical Insurance （URBMI） on medical service utilization. Methods： Based on data of China Health and Nutrition Survey, matching DID model was used to compare the changes in medical service utilization between residents participated in this system and those not participated in this system in 2009. Results： In initial stage of implementation, URBMI in a certain extent promoted medical service utilization of residents participated in the system, but the impact level was still low. The promoting effect on inpatient service utilization was significant, but very limited on outpatient service utilization. Conclusion： Promoting outpatient service utilization and increasing compensation are future priorities for improving URBMI to implement the system.