商业健康保险待遇对医疗经济负担的影响

Impact of commercial health insurance treatment on medical economic burden

[目的]探讨商业健康保险待遇对居民医疗经济负担的影响效应及作用机制。[方法]采用OLS模型对2019年中国家庭金融调查(CHFS)数据进行分析,使用工具变量法和中介效应模型分别进行内生性处理和机制分析。[结果]商业健康保险待遇每提升1.00%,会使居民医疗总费用提高0.05%(P<0.01),而使自付医疗费用占医疗总费用的比例显著降低(P<0.01)。使用工具变量法进行内生性处理后结果仍然显著。机制分析发现,患者是否门诊和住院就医是重要的中介渠道(P<0.01)。异质性分析结果表明,商业健康保险对农村和低收入组居民医疗总费用的正向影响更大,对降低城镇居民和高收入组居民的自付医疗费用占医疗总费用比例的效果更强。[结论]商业健康保险能够释放居民医疗需求,缓解居民医疗经济负担。

Objective To explore the effect and mechanism of commercial health insurance treatment on residents medical economic burden.Methods The data of 2019 China Household Finance Survey(CHFS)were analyzed by using OLS model.Instrumental variable method and mediation effect model were used for endogenous processing and mechanism analysis,respectively.Results Every 1.00%increase in the treatment of commercial health insurance increased the total medical expenses of residents by 0.05%(P<0.01),and significantly reduced the proportion of out-of-pocket medical expenses in the total medical expenses(P<0.01).The results were still significant after endogenous processing with instrumental variable method.Mechanism analysis showed that whether patients were outpatients or hospitalized was an important intermediary channel(P<0.01).The results of heterogeneity analysis showed that commercial health insurance had a greater positive impact on the total medical expenses of rural residents and low-income residents,and had a stronger effect on reducing the proportion of out-of-pocket medical expenses in the total medical expenses of urban residents and high-income residents.Conclusions Commercial health insurance can release residents medical needs and ease residents medical economic burden.