新型农村合作医疗制度对农村居民的健康影响研究

Study on the influence of new rural cooperative medical care system to rural residents' health

[目的]研究新型农村合作医疗制度对农村居民健康的影响,为中国医改的进一步完善提供决策依据。[方法]基于中国健康和营养调查(CHNS)中2004年和2009年的农村成人门诊调查数据,运用倍差法和倾向得分匹配法相结合的方法,就新农合的健康影响效应进行实证检验。[结果]老年人群和高收入人群参合者的自评健康分别下降了18.4%和11.4%,高收入人群参合者的患病率显著提高了5.6%,中青年人群参合者的保健率显著提高了1.8%。[结论]新农合对参合者的健康水平和医疗服务利用率无显著改善,其健康绩效和农民收入相关。建议加大对农村弱势群体的医疗保障,促进医疗机构竞争等,切实提高农民的收入水平,以提高新农合的健康效应。

Objective Study the influence of new rural cooperative medical care system （NRCMCS） to rural residents＇ health so as to provide decision basis for perfecting Chinese medical health care reform. Methods Based on rural adults outpatient survey data from 2004 to 2009 in China Health and Nutritional Survey （CHNS）, the paper assessed empirical test to health influence effect of NRCMS by difference- in difference and score matching Methods. Results The Results showed that self - assessment health score of NRCMS elders and high - income groups decreased 18.4% and 11.4% respectively. Prevalence rate of NRCMCS high -income groups significantly increased 5.6%. Health rate of NRCMCS young and middle - aged significantly increased I. 8%. Conclusions There was no significant improvement of NRCMCS to health level and health care service of participants. Health performance of the NRCMS is related to the income of the farmers. The paper puts forward that strengthening medical security for the weak in rural areas and promoting the competition of medical institutions. It will help to improve the health effect of the NRCMS with improving the income level of farmers.