大病保险对我国中老年人家庭灾难性卫生支出影响实证分析

An empirical analysis of the impacts of catastrophic diseases insurance on health expenditure for middle-aged and elderly people in China

目的:考察大病保险对我国中老年人家庭灾难性卫生支出的影响,为完善我国大病保险制度提供建议。方法:以中国健康与养老追踪调查数据库(2011年与2015年)中45岁及以上的城乡中老年人家庭作为研究对象,利用描述性统计法和两部模型法分析大病保险对我国中老年人家庭灾难性卫生支出的影响。结果:目前的大病保险政策从总体上降低了中老年人家庭灾难性卫生支出的发生率,但没有显著降低其发生强度。结论:目前的大病保险并未达到其预期的效果,只是解决了“面”的问题,从总体上降低了灾难性卫生支出发生的可能性,但并没有解决“点”的问题,没有有效降低其大额的医疗卫生支出进而减少其医疗经济负担。建议各地各级政府相关部门应进一步完善大病保险制度,从而真正有效减轻居民重大疾病医疗经济负担。

Objective:To investigate the impacts of catastrophic disease insurance on health expenditure for middle-aged and elderly people in China,and to provide reference for improving China's catastrophic disease insurance system.Methods:The urban and rural elderly people aged 45 and above in the China Health and Retirement Longitudinal Survey (CHARLS) Database (2011 and 2015) were used as research objects,using descriptive statistics and two-part model method to analyze the impacts of catastrophic disease insurance on health expenses for the surveyed people in their respective age groups.Results:The catastrophic diseases insurance has significantly reduced the incidence of staggering expenses that were spent on middle-aged and elderly people to a certain extent.However,it has not significantly reduced the intensity of those expenses.Conclusion:The current catastrophic diseases insurance has not achieved its expected results.The existing policy only solves the problem of “face”,which reduces the possibility of staggering health expenditure from the overall situation.On the contrary,it does not solve the problem of “points”,which does not effectively attain the expected reduction of health expenses and medical economic burden is not relieved.It is suggested that relevant departments in different governments at various levels should further improve the catastrophic diseases insurance system in the future,so as to effectively relieve the economic burden that residents face.