医疗需求与中国医疗费用增长--基于城乡老年医疗支出差异的视角

Medical Demand and Growing Medical Costs in China-Based on the Gap between Senior Citizens' Medical Costs in Urban and Rural Areas

在人口老龄化和老年医疗支出城乡差异凸显的背景下,中国医疗费用增长部分源于合理的健康需求。利用中国营养与健康调查1991—2011年的八轮数据,构造出生组跟踪样本,分别考察城乡居民医疗支出的年龄效应,估算城乡老年医疗需求导致的费用上涨,可以发现:城市居民的人均医疗支出随年龄显著增加,但农村居民的人均医疗支出随年龄增长的趋势并不明显。而忽略出生组效应,会低估城乡老年医疗支出的差距。城乡老年医疗支出差距缩小,将导致医疗费用在2010—2030年年均实际增长约5.2%。在控制医疗总费用上涨的同时,医疗保险制度需根据老年医疗需求,调整医疗资源配置结构。

In the context of population ageing and the growing gap in senior citizens' medical costs between urban and rural areas,China's rising medical costs are partly due to rational demand for healthcare.Using data from eight rounds of the China Health and Nutrition Survey from 1991 to 2008,we created birth cohort tracking samples to study the age effect on medical costs in urban and rural areas.Estimating the rise in costs caused by senior citizens' medical needs in urban and rural areas,we found that urban residents' average medical costs showed a marked rise with age,but there was no clear trend in the medical costs of rural residents over the age of 65.Ignoring the birth cohort effect results in underestimation of the gap between urban and rural medical costs for the elderly.Reducing this gap would result in an average rise in real medical costs of around 5.2 percent per annum between 2010 and 2030.Population ageing exerts greater pressure on rising medical costs in China than in developed countries.The health insurance scheme should adjust the distribution of medical resources in accord with the medical needs of the elderly at the same time as it keeps medical costs under control.