灾难性卫生支出水平及影响因素研究——基于CHARLS数据的分析

Study on Catastrophic Health Expenditure Level and Influencing Factors——An Analysis Based on CHARLS Data

研究灾难性卫生支出水平及其影响因素具有重要现实意义。本文基于2015年CHARLS全国数据,分析发现:灾难性卫生支出的发生率和因病致贫率分别为16. 5%和8. 6%,实际发生灾难性卫生支出的家庭平均将64%的非食品消费支出用于支付医疗费用;家庭规模和健康特征变量、经济特征变量、地区特征变量对家庭是否受到灾难性卫生支出具有显著性影响,家庭规模较小、健康状况较差、经济实力较弱、居住在农村地区的家庭更容易受到灾难性卫生支出的影响。为提高居民抵御灾难性卫生支出风险的能力,本文建议,应建立基于预防的重特大疾病医疗保障制度,加大对易发灾难性卫生支出风险家庭的支持,提高城乡居民特别是低收入群体的支付能力,合理确定自付医疗费用水平。

It is of great practical significance to study the level of catastrophic health expenditure and its influencing factors. The empirical analysis of the 2015 CHARLS data found that, about 16.5% of the households suffered catastrophic health expenditure, and the rate of poverty caused by catastrophic health expenditure was 8.6% , the households who actually suffered catastrophic health expenditure spend an average of 64% of their non -living expenses on medical expenses. Household size and health characteristic variables, economic characteristic variables and regional characteristic variables have significant influence. In order to improve the capacity of preventing the occurrence of catastrophic health expenditure, the paper puts forward four suggestions, including the establishment of a security system for serious illness based on prevention, the increased support for households prone to catastrophic health expenditure, the improvement of the income level especially the low - income groups, and the rational determination of the self - paid medical expenses.