城乡居民医保整合改善了农村居民的生活质量吗——基于医疗、健康与经济三维视角的政策绩效评估

Has the Integration of Urban and Rural Residents’Medical Insurance Improved the Quality of Life for Rural Residents--A Policy Performance Evaluation from the Perspectives of Medical Care,Health,and Economy

基于2013—2018年中国健康与养老追踪调查面板数据,采用PSM-DID模型,从医疗、健康及经济三个维度评估城乡居民医保整合对于改善农村居民生活质量的政策绩效,结果发现,城乡居民医保整合提升了农村居民医疗服务利用率,增进了生理、自评健康及生活满意度,并对收入、消费产生积极的溢出效应。从异质性上看,医疗绩效方面,城乡居民医保整合对农村老年人、女性居民及高收入居民的影响效应更大;健康绩效方面,城乡居民医保整合有利于提升农村老年人、男性居民的生理健康水平,以及提升年轻人、高收入居民的心理健康水平;经济绩效方面,城乡居民医保整合对农产品收入、工资收入及社保转移收入的提升效应更大,对高级消费的提升效应大于低级消费。基于此,建议继续深化医疗卫生体制改革,建立农村弱势群体医疗救助机制,充分发挥医疗保险在提升农村居民生活质量方面的积极作用。

Based on the panel data from the China Health and Retirement Longitudinal Study between 2013 and 2018,this article uses the PSM-DID model to evaluate the performance of the integration of urban and rural residents’medical insurance policy in improving the quality of life of rural residents from three dimensions:medical care,health and economy.The study finds that the integration of urban and rural residents’medical insurance increases the utilization rate of medical services for rural residents,improved physiological health,self-assessed health,and life satisfaction,and has positive spillover effects on income and consumption.From the perspective of heterogeneity,in terms of medical performance,the integration of urban and rural residents’medical insurance has a greater impact on the rural elderly,rural female residents and rural high-income residents.In terms of health performance,the integration of urban and rural residents’medical insurance can improve the physiological health level of rural elderly and male residents,and can improve the mental health of rural young people and high-income residents.In terms of economic performance,the integration of urban and rural residents’medical insurance has a higher improvement effect on the income of agricultural products,wages,and social insurance transfer income,and has a higher improvement effect on high-level consumption compared to low-level consumption.Based on this,it is suggested to continue to deepen the reform of the medical and health system,establish a medical assistance mechanism for rural vulnerable groups,and give full play to the positive role of medical insurance in improving the quality of life of rural residents.