医疗保险是否改善了老年人的慢性病医疗状况?--基于CHARLS数据的实证分析

Has Medical Insurance Improved the Medical Condition of Elderly Chronic Diseases?Analysis Based on CHARLS

本文基于中国健康与养老追踪调查(CHARLS)数据,利用Heckman样本选择模型、二阶段最小二乘模型(2SLS)等方法,在高血压、糖尿病等慢性病纳入医保门诊报销的背景下,实证检验了医疗保险对我国城乡老年人慢性病医疗状况的影响。研究发现:(1)医疗保险显著增加了老年人慢性病的门诊和住院医疗费用,且城市和男性老年人的支出明显高于农村和女性老年人,但医疗保险对老年人慢性病住院医疗支出增长的影响呈减弱趋势;(2)医疗保险显著提高了老年人慢性病医疗服务利用率,增加了老年人及时就医的概率;(3)医疗保险显著降低了老年人慢性病的自付比例,减轻了老年人的医疗负担。

Based on the data of China Health And Retirement Longitudinal Study(CHARLS),this paper uses Heckman sample selection model and two stage least square model(2SLS model)to make an empirical study of the effect of medical insurance on the chronic medical condition of the elderly in urban and rural China in the context of hypertension,diabetes and other chronic diseases included in medical insurance outpatient reimbursement.It comes to the conclusions as follows:firstly,medical insurance has significantly increased the outpatient and inpatient medical expenses for chronic diseases of the elderly but the increasing effect of medical insurance on inpatient medical expenditure of chronic diseases shows a decreasing trend.The expenditures of male elderly and urban elderly are significantly higher than those of female elderly and rural elderly;secondly,medical insurance has effectively improved the utilization of medical services for the elderly with chronic diseases and increased the probability of timely medical treatment for the elderly;thirdly,medical insurance has significantly reduced the out-of-pocket proportion of chronic diseases among the elderly and reduced the medical burden on the elderly.