中国医疗卫生体制改革的健康及医疗服务效应——基于综合医改试点的考察

Health and medical service effects of China’s health care systemreform: Evidence from “comprehensive medical reform”

深化医疗卫生体制改革是推进健康中国建设的重要举措.本文借助综合医改试点的准自然实验,探讨了中国医疗卫生体制改革对居民健康的作用.研究发现,综合医改政策显著提升了居民主观健康和客观健康.进一步,从“看病难”角度,综合医改提升了居民就医满意度、医疗水平认可度和医疗服务可及性;从“看病贵”角度,综合医改提高了医疗保险覆盖率,并降低了居民医疗负担.异质性分析发现,综合医改对城镇居民、女性和老年群体的健康效应更大,农村地区仍是未来医疗卫生体制改革的重难点区域.

The deepening of healthcare system reform is a critical step towards building a healthier China.By employing the quasi-natural experiment method on comprehensive healthcare reform pilots,we examine the effects of healthcare system reform on Chinese residents’health.Our findings suggest that comprehensive healthcare reform significantly improves residents’subjective and objective health statuses.Moreover,from the perspective of“difficulties in seeking medical attention”,our results show that the reform enhances patient satisfaction,approval of medical standards,and the accessibility of medical services.When viewed from the“high medical cost”perspective,the reform has expanded medical insurance coverage and reduced residents’financial burden of healthcare.Our heterogeneous analysis reveals that the comprehensive healthcare reform has a more significant health impact on urban residents,women,and the elderly,highlighting rural areas as the focus of future healthcare system reform efforts.