摘要
本文根据安徽舒城县农村地区的抽样调查数据,采用Tobit模型和半参数回归模型,研究了农村居民间接医疗费用问题。研究发现,间接医疗费用是不可忽视的经济负担,能够使得农村居民实际报销比例平均下降7个百分点,在全部自付医疗费用中平均占比为12.2%,疾病严重情况下甚至会超过50%。直接医疗费用每增加1%,间接医疗费用占全部自付费用的比重增加2.25%;直接医疗费用对间接医疗费用的影响存在天花板效应,直接医疗费用超过约5000元之后,间接医疗费用占比不再继续增加;家庭抚养负担、居住地位置偏远程度、家庭主要劳动力是否患病等因素会显著影响间接医疗费用占比。在应对间接医疗费用方面,农村居民主要依靠的外界力量是亲戚帮助,政府补贴也发挥了有限作用,但仍有较大提升空间。本研究有助于在巩固脱贫攻坚成果背景下深入认识农村居民的实际医疗负担,为完善农村社会保障体系和推动城乡基本公共服务均等化提供支撑。
Based on the sample survey data of rural areas in Shucheng County,Anhui Province,this article uses the Tobit model and semi-parameter regression model and analyzes the indirect medical expenses of rural residents.The study finds that indirect medical expenses is a financial burden that cannot be ignored.It can reduce the actual reimbursement ratio by an average of 7 percentage points,accounting for 12.2%of the total out-of-pocket expenses and even more than 50%in severe cases.For every 1%increase in direct medical expenses,the proportion of indirect medical expenses will increase by an average of 2.25 percentage points.The impact of direct medical expenses has a ceiling effect,after more than about 5000 Yuan,the proportion of indirect medical expenses will not continue to increase.The proportion of indirect medical burden in out-of-pocket expenses can be significantly affected by family support burden,the location of residence,and whether the main labor force is sick or not.In response to the indirect medical burden,rural residents mainly rely on the help of relatives,and government subsidies also play a limited role,but there is still much room for improvement.This study helps to understand the actual medical burden of rural residents in the context of consolidating the achievements of poverty alleviation,and provides support for improving the rural social security system and promoting the equalization of basic public services in urban and rural areas.
作者
詹鹏
尹丽萍
叶林祥
ZHAN Peng;YIN Liping;YE Linxiang
出处
《中国农村观察》
CSSCI
北大核心
2021年第3期48-66,共19页
China Rural Survey
基金
国家社会科学基金重大项目“新时代我国农村贫困性质变化及2020年后反贫困政策研究”(项目号:19ZDA116)
教育部人文社科基金青年项目“减贫目标约束下的多维贫困微观模拟模型研究”(项目号:18YJC910015)的阶段性研究成果。
关键词
农村居民医疗费用
间接医疗费用
陪护费用
公共服务可及性
机会成本
Rural Residents’Medical Expense
Indirect Medical Burden
Accompanying Expense
Public Service Accessibility
Opportunity Cost
