中国城乡老年人医疗行为及其 健康差异影响因素

Medical Behavior and Health Differences between Urban and Rural Elderly under the Healthy China Strategy

医疗消费作为健康需求的衍生物,对不同人群的医疗消费需求满足都有着重要的作用。结合城乡老年人医疗行为与健康差异,以基本医保为核心,利用CFPS调查数据库2018年的调查数据,实证检验了中国老年人医疗消费行为及其健康差异的核心影响因素。结果显示,享受公费医疗、城镇职工医保与城镇居民医保显著提升了老年人选择综合医院就诊概率,显著降低了老年人选择非综合医院就诊概率,而新农合对老年人的就医选择与前三类保险作用机制恰好相反,且收入是重要制约因素。老年人医疗消费总量或自付医疗费用对健康水平却有显著的负向效应。分城乡样本差异性检验结果显示,城市老年人医疗总费用对自评健康降低作用要高于农村老年人。因此,尝试从基本医保制度设计、支付方式优化及医疗消费行为等方面提出相应的政策思考。

As a derivative of health needs,medical consumption plays an important role in meeting the medical consumption needs of different populations.This article combines the medical behaviors and health differences of the elderly in urban and rural areas,takes basic medical insurance as the core,and uses the 2018 survey data of the CFPS to empirically test the core influencing factors of the medical consumption behaviors and health differences of the elderly in China.The results show that enjoying public medical care,urban employee medical insurance and urban resident medical insurance significantly increases the probability of elderly people choosing to visit a general hospital.And significantly reduces the probability of elderly people choosing a non-general hospital.The total medical consumption of elderly or out-of-pocket medical expenses has a significant negative effect on health.The results of the difference test between the urban and rural samples show that the total medical cost of the elderly in the city has a lower effect on self-assessed health than the elderly in the rural area.According to the conclusions of the study,the article attempts to provide corresponding policy considerations in terms of basic medical insurance system design,payment method optimization,and medical consumption behavior.