基于tobit模型的居民医疗费用支出影响因素研究

Study on the factors influencing the medical expenditure of residents based on tobit model

目的分析我国居民医疗费用支出情况及其影响因素,为控制居民医疗费用支出不合理增长提供对策建议。方法使用2020年中国家庭追踪调查(CFPS)数据,采用非参数检验和tobit回归模型对其进行统计分析。结果tobit回归模型分析结果显示,农村(Me=-674.089)、男性(Me=-700.585)、中学(Me=-798.255)、健康自评一般(Me=-6944.941)、比较健康(Me=-10606.441)、健康(Me=-13122.873)、很健康(Me=-16432.990)的居民医疗费用支出低;年龄≥60岁(Me=1264.808)、患有慢性病(Me=9746.321)、综合医院/专科医院(Me=3625.865)、新农合/城乡居民医保(Me=1523.693)、城镇居民医保/城镇职工医保(Me=1550.252)的居民医疗费用支出高。结论居住地、性别、年龄、受教育水平、就诊医疗机构、医保类型均是居民医疗费用支出的影响因素,因此提出提升全民健康素养,深化医疗保险制度改革,推动优质医疗资源下沉,提升基层医疗体系服务能力等建议,以减轻居民医疗费用支出,防止因病致贫、因病返贫等现象发生。

Objective To analyze the situation and influencing factors of medical expenditure in Chinese residents and provide countermeasures and suggestions for controlling the unreasonable growth in the medical expenditure of residents.Methods The data of China Family Panel Studies(CFPS)in 2020 were analyzed by non-parametric test and tobit regression model.Results The results of the tobit regression model analysis showed that the residents of rural(Me=-674.089),male(Me=-700.585),middle school(Me=-798.255),general health self-assessment(Me=-6944.941),relatively healthy(Me=-10606.441),healthy(Me=-13122.873),and pretty healthy(Me=-16432.990)had low medical expenditure;The residents aged≥60(Me=1264.808),residents with chronic diseases(Me=9746.321),general hospitals/specialized hospitals(Me=3625.865),New Rural Cooperative/Urban and Rural Resident Medical Insurance(Me=1523.693),Urban Residents/Urban Employee Medical Insurance(Me=1550.252)had high medical expenditure.Conclusion Residence,gender,age,degree of education,medical institutions,and type of medical insurance are influencing factor for the medical expenditure of residents.Therefore,it is proposed to improve the health literacy of the whole population,deepen the reform of the medical insurance system,promote the sinking of high-quality medical resources,and enhance the service capacity of the primary medical care system for alleviating the medical expenditure of residents,which prevents the occurrence of poverty and return to poverty due to illness.