精准扶贫、人情支出与农村家庭医疗负担

The Impact of Targeted Poverty Reduction Policy on Medical Burden of Rural Family

文章在揭示家庭医疗负担与人情支出关系的基础上,评价了精准扶贫政策对农村大病家庭医疗负担的影响。使用Tobit模型和处理效应模型分析表明,农村家庭人情支出指标可以作为监测大病家庭医疗负担是否沉重的"风向标",大病冲击会减少家庭的人情支出;目前精准扶贫政策对建档立卡家庭(贫困户)的大病医疗负担缓解效果显著,并且有效遏制了"因病致贫";非建档立卡大病家庭(非贫困户)更易遭受沉重的医疗负担,并在大病冲击下呈现出一定的脆弱性;对于非贫困户来说,当期患有大病对家庭医疗负担影响较大,随着时间推移,大病对家庭负担的影响逐渐减弱。因此,在贫困户识别方面,除了从家庭人均收入和财产状况进行识别外,将人情支出的变动作为识别维度有利于实现更为精准的贫困户识别。文章建议采用人情支出的变动来监测建档立卡贫困户医疗负担是否沉重,以及是否属于"因病致贫"。

This paper evaluates the influence of targeted poverty reduction policy on the medical burden of rural families with major illnesses in perspective of correlation between family medical burden and gift expenses. Employing Tobit Model and Treatment Effect Model, we find that the occurrence of serious illnesses reduces gift expenses of rural families, which acts like a"wind indicator"in monitoring the medical burden of family with serious illnesses. The targeted poverty alleviation policy has a very significant effect in alleviating the medical burden for families with major illnesses, and it effectively curbs the"disease-led poverty". The families with serious illnesses which have not entered the list of established state cards(non-impoverished households) are still more vulnerable to heavy medical burdens, and they show some vulnerability to major illnesses. For non-impoverished households, the current illness has a great impact on the family's medical burden, although it declines gradually over time. Therefore, in addition to household income per capita and property status, it is important to take into consideration of changes in gift expenditure in order to identify and targetpoverty more accurately. It is also possible to monitor changes in gift expenditures and judge whether the poor households are heavily burdened with medical treatment and whether they are"disease-led poverty".