城乡居民医保整合对农村中老年人心理健康的影响

Study on the Impact of Urban-Rural Health Insurance Integration on the Mental Health of Middle-Aged and 01-der Adults in Rural Areas

目的:分析城乡居民医保整合对农村中老年人心理健康的影响及作用机制,为政策制定提供参考。方法:使用中国健康与养老追踪调查(China Health and Retirement Longitudinal Study, CHARLS)2011年、2013年、2015年和2018年四期面板数据,运用多期双重差分法评估城乡居民医保整合对农村中老年人心理健康的影响,同时分析性别、慢性病和地区异质性,并进一步检验功能受限和劳动参与的中介效应。结果:城乡居民医保整合可以改善农村中老年人心理健康(P<0.01),对男性、西部地区农村中老年人有更显著的作用,但是在是否患有慢性病方面没有存在差异。城乡居民医保整合可能通过功能受限、劳动参与对农村中老年人的心理健康产生影响。结论:城乡居民医保政策可能对农村中老年人的心理健康产生影响,政府应关注城乡居民医保政策在心理健康方面的效益,在政策制定中充分考虑不同特征农村中老年人的差异,提高统筹层次,强化区域间协同。

Objective To analyze the effect and mechanism of medical insurance integration of urban and rural residents on the mental health of middle-aged and older adults in rural areas,and provide scientific basis for policy making.Methods Data of the China Health and Retirement Longitudinal Study(CHARLS 2011,2013,2015 and 2018)were used to evaluate the effect of urban-rural health insurance integration on the mental health of middle-aged and older adults in rural areas by using the multi-period differences-in-differences method.And the heterogeneity of gender,chronic diseases and region were analyzed to further examine the mediating effects of functional limitations and labor participation.Results Urban-rural health insurance integration can improve the mental health of middle-aged and older adults in rural areas(P<0.01),especially for males and middle-aged and older adults in the western region,while there was no difference in the impact in terms of whether having chronic diseases.Urban-rural health insurance integration has an impact on mental health of middle-aged and older adults in rural areas through functional limitations and labor participation.Conclusion Urban-rural health insurance integration policy may have an impact on the mental health of middle-aged and older adults in rural areas.The government should pay attention to the effect of urban-rural health insurance integration on the mental health of middle-aged and older adults in rural areas,fully consider the differences among middle-aged and older adults in rural areas with different characteristics in policy formulation,improve the overall planning level,and strengthen regional coordination.