基本医疗保险对农村老人医疗负担影响研究

Studying on the Influence of Basic Medical Insurance on Medical Burden of the Rural Elderly

目的:分析基本医疗保险对农村老人医疗负担的影响,为完善基本医疗保险制度提供依据。方法:以4976个60岁及以上农村老人为研究对象,通过构建两部模型与广义线性模型,分析基本医疗保险等变量对农村老人医疗负担的影响。结果:基本医疗保险能够显著降低高收入和高医疗支出农村老人的医疗自付费用31.2%(P<0.05)和22.1%(P<0.05),使农村老人的医疗支出比例下降2.4%(P<0.1),能够提升农村老人的就医概率16.8%(P<0.1);农村老人的健康状况是影响老人就医概率与医疗费用的重要因素;农村老人的就医概率与医疗费用呈现明显的地域性。结论:基本医疗保险降低了部分农村老人医疗负担,促进了农村老人医疗服务利用。应推进完善医保政策,适当调整医疗资源配置,平衡地区之间的差异,提升农村老人群体健康水平以缓解医疗负担。

Objective To analyze the influence of basic medical insurance on medical burden of the elderly in rural areas,and provide references for improving the basic medical insurance system.Methods A total of 4976 rural elderly aged over 60 years were selected as the research object.The influences of basic medical insurance and other variables on medical burden of rural elderly were analyzed by constructing two-part model and generalized linear model.Results Basic medical insurance can significantly reduce the out-of-pocket medical expenses of the rural elderly with high income and high medical expenses by 31.2%(P<0.05)and 22.1%(P<0.05),respectively,reduce the proportion of medical expenses of the rural elderly by 2.4%,and improve the probability of medical treatment of the elderly in rural areas by 16.8%.The health status of the elderly in rural areas is an important factor to influence the probability of medical treatment and medical cost of the elderly.The probability of medical treatment and medical cost of the elderly in rural areas were obviously regional.Conclusion Basic medical insurance reduces the medical burden of the elderly in rural areas,and promotes the utilization of medical services for the elderly in rural areas.It is necessary to improve the medical insurance policy,adjust the allocation of medical resources,balance the differences among different regions,and improve the health level of the elderly population in rural areas to relieve the medical burden.