医疗保险、卫生服务利用与过度医疗需求——医疗保险对老年人卫生服务利用的影响

Medical Insurance,Health Services Utilization and Excessive Demands for Medical Services——The Impact of Medical Insurance on Utilization of Health Service of the Elderly

基于老年人全国调查数据,运用工具变量法,在解决模型内生性问题的基础上,发现医疗保险对老年人卫生服务利用的影响显著,能促使老年人每年多支出医疗费用2 420元,而普通最小二乘法的估计结果会显著低估医疗保险的这一影响。进一步利用工具变量法和Probit模型进行分析可以发现,医疗保险会显著提高老年人过度利用卫生服务的可能性。

The impact of medical insurance on utilization of health services of the elderly deserves attention. On the basis of national survey data of the elderly,through using Instrument Variable Method and solving the model of endogenous,it has been found that the elderly with medical insurance will spend more in annual health care expenditure by about 2420 Yuan,which suggests that medical insurance will significantly promote the elderly utilization of health services. While the estimation results from using Least Square Method has significantly underestimated this promotion effect made by medical insurance. Further by using the Instrumental Variable and the Probit model,there appears the possibility that medical insurance may promote the elderly over utilize the health services. It is proposed to optimize the health resource allocation of medical institutions at all levels and improve medical insurance system with the explanation mechanism of compelled excessive medical consumption.