相对贫困视域下医疗保障对农村中老年人群因病支出型贫困的减贫效果分析

Analysis ofthe poverty alleviation effect of medical security on illness-induced poverty among the middle-aged and elderly people in rural areas in the context of relative poverty

目的:对我国东中西部地区农村中老年贫困人口各部分医疗费用导致的因病支出型贫困状况进行分析,模拟医疗保障政策对门诊和住院的减贫效果,为减轻农村贫困人口因病支出型贫困风险提供针对性建议。方法:采用FGT指数对我国东中西部地区农村贫困人口医疗保障补偿前后的因病因病支出型贫困进行测算,模拟医疗保障在不同补偿比例下的减贫效果;采用经济发展水平与贫困状况相结合的方式筛选东中西部地区代表性省份,对贫困人口的医疗保障政策进行分析讨论。结果:各地区趋同化贫困人口倾斜性医保政策水平与地区差异性贫困特征不匹配;各地区自我治疗费用导致的支出型贫困不容忽视;各地区门诊支出型贫困更为严峻,但医保减贫效果较好;医保缓贫效果大于减贫效果。结论:医疗保障政策对改善贫困状况产生了积极作用,且存在地区差异,应结合地区经济情况与贫困状况,完善医保扶贫措施。

Objectives:To analyze the poverty caused by various medical expenses due to illness among the rural middle-aged and elderly population in the eastern,central and western regions of China;to simulate the poverty alleviation effect of medical security policies on outpatient and hospitalization;and due to health risk,to assess the possibilities of poverty alleviation among the target subjects of this research,as well as to provide targeted recommendations for effective implementation of the poverty alleviation policies.Methods:The FGT index was used to measure the expenditure-based poverty of the rural poor people in different regions of China before and after medical security compensation,and the poverty alleviation effects of different medical security levels were further simulated.The method of combining the levels of economic development and poverty was used to screen the representative provinces in the eastern,central and western regions for analysis and discussion of medical security policies of the poor.Results:The level of preferential medical insurance policies for the poor population in various regions does not match with the characteristics of regional differences in poverty.It is obvious that the illness-induced poverty caused by self-treatment expenses in various regions is significant,the out-patient expenditure-based poverty is more severe,and outpatient compensation has a better effect on poverty alleviation.The poverty alleviation effect of medical insurance is greater than that of poverty reduction,and regional differences are obvious.Conclusions:Medical security policies have played a positive role in reducing poverty,and regional differences in poverty reduction and alleviation effects are obvious.It is necessary to improve medical insurance and review the poverty alleviation measures based on region-wise economic status of poor people in the class of middle-age and elderly in order to have a better regional poverty alleviation effect.