父母参加社会医疗保险对儿童健康的影响研究——基于CHNS数据的实证分析

Study of the impact of parental participation in social medical insuranceon children's health:an empirical analysis based on CHNS data

增强社会医疗保险对儿童健康的保障能力是提升社会医疗保险效能的有效路径。基于1991—2015年九期中国健康与营养调查数据,利用固定效应模型研究父母医疗保险对儿童健康的影响并检验其内在机制,结果显示:父母参加社会医疗保险具有代际“溢出效应”,能显著促进儿童健康水平的提升,对儿童的健康保障起到补充作用。异质性分析结果表明,父母参加社会医疗保险对城市户籍及西部欠发达地区儿童的健康促进效果更加显著。机制检验结果显示,正规就医可以增强父母参加社会医疗保险对儿童健康的正向影响,健康检查则会削弱父母参加社会医疗保险对儿童健康的正向影响。由此,提出通过倾斜性医保政策、探索家庭联保提高基本医疗保险的保障水平,增强农村地区、欠发达地区的基本医疗保险保障能力,引导家庭有效利用医疗卫生资源,以及有针对性地给予家庭预防保健服务保障等建议。

Enhancing the ability of social medical insurance to guarantee children's health is an effective way to improve the effectiveness of social medical insurance.Based on the data of the nine China Health and Nutrition Survey from 1991 to 2015,this paper uses the fixed-effect model to study the impact of parental participation in medical insurance on children's health and examine its internal mechanism.The results show that parental participation in social medical insurance has intergenerational"spillover effect",which can significantly promote the improvement of children's health and play a complementary role in children's health security.The results of heterogeneity analysis show parental participation in social medical insurance has a more significant effect on the health of children with urban household registration and children in less developed areas in western China.The results of the mechanism test show that formal medical treatment can enhance the positive impact of parental participation in social medical insurance on children's health,while health examination can weaken the positive impact of parental participation in social medical insurance on children's health.Therefore,it is proposed to improve the level of basic medical insurance through implementing preferential medical insurance policies and exploring family insurance,strengthen the security ability of basic medical insurance in rural areas and less developed areas,guide families to make effective use of medical and health resources and provide targeted family preventive health care services.