| 引用本文: |
马桂峰,蔡伟芹,王培承,等.我国不同社会医疗保险参保群体卫生服务利用不平等研究[J].中国卫生经济,2017,(12):28-31.[点击复制] |
.Inequality of Health Care Utilization Between Three Social Medical Insurance[J].CHINESE HEALTH ECONOMICS,2017,(12):28-31.[点击复制] |
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| 摘要: |
| 目的：分析我国参加城镇职工医疗保险、城镇居民医疗保险和新型农村合作医疗制度的各类群体卫生服务利用情况，比较三种医疗保险群体间卫生服务利用的不平等程度，并对不平等进行相关因素的分解测算。方法：利用现场调研获得的全国6个省16个市31个县市区的8 676名居民的卫生服务利用情况。利用集中指数和集中曲线测算各省、市和县的居民卫生服务利用不平等情况。利用回归分析和集中指数分解等方法测算分别参加三种医疗保险的群体卫生服务利用不平等和标化后的不平等之间的差异。结果：以居民家庭人均收入为参照，测算我国2014年居民的卫生服务利用集中指数为0.114 0，其中辽宁省为0.088 2，安徽省为-0.066 4，山东省为0.166 2，河南省为0.203 1，陕西省为0.227 6，宁夏回族自治区为0.101 8。全国城镇职工医疗保险参保群体卫生服务利用的集中指数为0.153 4，城镇居民医疗保险的集中指数为0.109 7，新农合的集中指数为-0.037 4，其他保险的集中指数为0.224 4。男性居民的卫生服务利用集中指数为0.095 5，女性的为0.128 6。经回归方程分析，控制经济、年龄、地域等因素间接标化后的三种主要社会医疗保险参保群体卫生服务利用的集中指数分别是，城镇职工医疗保险：0.1332，城镇居民医疗保险：0.1225，新农合：0.0994，较未标化之前都有所改善。结论： 从集中指数反映的卫生服务利用不平等来看，辽宁省参保群体的卫生服务利用公平性较好，陕西省的不平等性较差。三种主要的社会基本医疗保险参保人群的卫生服务利用不平等性存在差异，城镇职工医疗保险的不平等性最大，次之为城镇居民医疗保险，新农合的不平等性最低。 |
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| Inequality of Health Care Utilization Between Three Social Medical Insurance |
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| Abstract: |
| Objective: To analyze our country in various groups of health services utilization of medical insurance for urban workers, medical insurance for urban residents and the new rural cooperative medical care, compared three groups of health service utilization degree of inequality, and inequality decomposition estimates related factors. Methods: The utilization of health services of 9836 residents in 6 provinces, 16 cities and 31 counties in 2014 was investigated by field investigation. The use of concentration index and concentration curve to calculate the health services of provinces, cities and counties to make use of inequality. The relative inequalities and normalization inequalities of the three medical insurance systems were calculated by regression analysis and concentration index decomposition. Results: The residents per capita household income as a reference, in 2014 China residents health service utilization concentration index was 0.1140, which was 0.0882 in Liaoning, Anhui province -0.0664, Shandong province is 0.1662, Henan is 0.2031, Shaanxi is 0.2276, Ningxia autonomous region 0.1018. The concentration index of health service utilization in the urban employees medical insurance group is 0.1534, the urban residents medical insurance is 0.1097, the new rural cooperative medical scheme is -0.0374, and the other insurance is 0.2244. The concentration index for male residents was 0.0955, compared with 0.1286 for females. By the analysis of the regression equation, the control of economy, age, geographical factors such as the standard of the three main social medical insurance groups using health service insurance concentration index respectively for 0.1332 urban employees’’ medical insurance, medical insurance for urban residents is 0.1225, 0.0994 is not the subject of NCMS, both before the change. Conclusion: From the perspective of the inequality reflected by the concentration index, the health service utilization equity of the insured groups in Liaoning province is fairly good, and the inequality in Shaanxi province is poor. The three main types of social medical insurance groups of health service utilization inequality differences, medical insurance for urban workers, the inequality of the largest, followed by the medical insurance for urban residents, the new rural cooperative medical unequal minimum. |
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