摘要
健康扶贫能够提高贫困户群体的健康状况,降低单次疾病经济负担,并在释放正常医疗服务需求的同时缓解疾病经济负担。本文利用中国健康与养老追踪调查(CHARLS)2011年和2018年数据,使用双重差分模型实证检验健康扶贫对贫困户群体年度疾病经济负担的影响及其实现路径。研究结果表明:第一,健康扶贫能够显著降低贫困户群体的年度住院经济负担,但对年度门诊经济负担的影响不显著;第二,从理论上讲,健康扶贫具有缓解年度门诊疾病经济负担的作用,但是贫困户群体中慢性病患者的正常医疗需求释放,在一定程度上抵消了这种效果,这是导致健康扶贫对年度门诊疾病经济负担无显著影响的重要原因;第三,慢性病群体的正常医疗需求释放最终主要表现在住院医疗服务利用方面。在建立医疗保障长效反贫机制过程中,应通过慢性病门诊统筹和慢性病医疗救助对易陷入贫困的低收入贫困边缘群体进行覆盖。
Poverty alleviation by improving healthcare can improve the health status of the poor households,reduce the economic burden of a single disease,and relieve the economic burden of the disease while releasing the demand for normal medical services.This paper uses data from the China Health and Retirement Longitudinal Study(CHARLS)from 2011 and 2018 to empirically use the model of difference in difference(DID)to test the impact of health poverty alleviation on the annual economic burden of diseases in poor households and its implementation path.The study results show that first,health poverty alleviation can significantly reduce the annual hospitalization economic burden of the poor households,but the impact on the annual economic burden of outpatient is not significant.Second,the release of normal medical needs of chronic disease patients in the poor households to some extent offsets the theoretical impact of health poverty alleviation on the annual economic burden of outpatient diseases.Both are important mechanisms that lead to no significant impact of health poverty alleviation policy on the annual outpatient economic burden.Third,the release of normal medical needs in chronic disease groups is ultimately mainly manifested in the utilization of inpatient medical service.In the process of establishing a long-term anti-poverty mechanism of medical security,the low-income groups and marginal groups of poverty with chronic diseases should be covered through the coordination of chronic disease outpatient service and chronic disease medical assistance.
出处
《中国医疗保险》
2022年第8期28-34,共7页
China Health Insurance
基金
国家社科基金一般项目“基本医疗保险对老年人临终医疗费用的影响效应与机制研究”(21BGL192)。
关键词
年度疾病经济负担
年度就医次数
单次就医经济负担
正常医疗需求释放
贫困边缘群体
annual economic burden of disease
annual medical visits
economic burden of a single medical treatment
release of normal medical demand
the marginal group of poverty
作者简介
张需,中南财经政法大学博士研究生在读,主要研究方向:医疗保险、健康经济学;通讯作者:吕国营,E-mail:guoyinglv66@163.com。
