不同医疗保险体系下的城乡中老年居民治疗行为实证分析

Study of the Health Care Utilization and Multi-health Insurance Schemes in China

运用"中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)2008"数据,采用Logit模型和Multi-nominal Logit模型,分析了不同医疗保险体系下城乡中老年医疗服务使用差异。结果表明:与新农合相比,其他医疗保险都提高了个体治疗行为发生概率,且商业医疗保险和城镇职工医疗保险分别显著提高治疗行为发生概率的44%和12%。在发生治疗行为情况下,不同医疗保险对治疗行为选择的差异影响并不显著。但例外的是,相对"自我治疗"行为,城镇职工医疗保险居民相对新型农村合作医疗覆盖人群会放弃"就诊+自我治疗"行为而选择"自我治疗"行为显著增加8%。

Using the China Health and Retirement Longitudinal Study （2008） data ,this paper explored the impacts of Multi-Health Insurance Schemes on health care utilization of the older adults .Logit model was used to estimate the probability of health care utilization and Multi-Nominal Logit model was used to estimate the probabilities of three health services ：self-medication , outpatient/inpatient care , both self-medication and outpatient/inpatient care . The findings suggested that compared with people covered by New Cooperative Insurance ,people with other health insurance schemes were more likely to utilize health care .The probability of health care utilization for people with private health insurance or Urban Resident Medical Insurance significantly increased by 44% and 12% ,respectively .Among those who had care service utilization ,there was no evidence that health insurance was significantly related to the probabilities of three health services .These results indicate that Multi-Health Insurance Schemes have a significant effect on the probability of health care utilization .However ,the impacts on the formal health services are still limited .