广东城乡居民基本医疗保险对居民住院服务利用的影响研究

Study on the influence of urban and rural resident basic medical insurance on the utilization of hospitalization services in Guangdong Province

基于中国家庭追踪调查(Chinese Family Panel Studies,CFPS)中广东样本数据,以住院次数而非住院费用作为应变量,采用倾向性得分匹配方法(Propensity Score Matching,PSM)分析广东城乡居民基本医疗保险对居民住院服务利用的影响。结果发现,在剔除了相关变量的影响之后,广东城乡居民基本医疗保险制度(本文简称“城居保”)对居民住院行为无显著影响。该结果与以前的文献有比较大的差异。笔者从应变量的选择、研究对象及方法的差异、医保支付制度的改革、慢病医保报销等5个方面分析了差异的原因,并指出了未来可行的研究方向。

Based on the sample data of Guangdong province in Chinese Family Panel Studies(CFPS),this paper takes hospitalization frequency instead of hospitalization cost as dependent variable,adopts PSM method(propensity score matching method)to analyze the influence of urban and rural basic residents medical insurance on the utilization of hospitalization services in Guangdong Province.The result finds that urban and rural basic resident medical insurance system in Guangdong province has no significant influence on residents hospitalization behavior after eliminating the influence of relevant variable.This result is quite different from previous literature.This paper analyzes the reasons for the differences from five aspects,such as selection of dependent variables,differences in research objects and methods,reform of medical insurance payment system and medical insurance reimbursement of chronic disease.It points out the feasible research direction in the future.