摘要
失能风险作为重要的健康冲击因素,其错综繁复的致贫返贫路径极易导致医疗支出型持久性贫困的发生。本文主要利用2011年、2013年、2015年和2018年四期中国健康与养老追踪调查微观面板数据,构建家庭持久灾难性卫生支出指标,从医疗支出型贫困视角动态解构家庭持久性贫困的关键维度。在此基础上,建立三重差分模型检验长期护理保险对失能家庭持久灾难性卫生支出的影响。结果表明,失能致贫普遍存在,长期护理保险能够有效降低失能家庭陷入持久灾难性卫生支出的可能性,使得失能家庭持久灾难性卫生支出发生率平均下降8.30%,发生周期平均减少0.1705年,发生深度平均减少0.2843个份额。长期护理保险对护理产业产生了正外部性,并通过降低失能家庭医疗支出和增加家庭成员劳动供给打破健康冲击和家庭灾难性卫生支出的恶性循环。进而,在对失能家庭减贫的同时,长期护理保险也带来了一定的健康福利,最终实现了“帕累托改进”。本文结论为相对贫困治理和长期护理保险制度优化提供了实证参考。
As an important factor of health shocks with its complicated path of causing poverty,disability risk has a strong ability to induce persistent poverty due to high burden of medical expenditures.This paper uses CHARLS data for the references years of 2011,2013,2015 and 2018 to build indicators of household persistent catastrophic health expenditure,and dynamically deconstructs the key dimensions of household persistent poverty from the perspective of poverty due to medical expenditure.On this basis,a DDD model is established to test the impact of Long-term Care Insurance(LTC)on the persistent catastrophic health expenditure of disabled families.The results show that poverty caused by disability is widespread,and LTC can effectively reduce the possibility of disabled families falling into the persistent burden of catastrophic health expenditure,so that the average incidence of the persistent catastrophic health expenditure of disabled families decreases by 8.30%,the average occurrence period decreases by 0.1705 years,and the average occurrence depth decreases by 0.2843 shares.LTC produces positive externalities to the nursing industry,and it breaks the vicious circle of disability and household persistent health expenditure by reducing the medical expenditure of disabled families and increasing the labor supply of family members.Furthermore,while reducing the poverty of disabled families,LTC also generates certain health benefits,and finally realizes“Pareto improvement”.The conclusion of this paper provides an empirical reference for the governance of relative poverty and the optimization of LTC.
作者
朱铭来
申宇鹏
康琢
ZHU Minglai;SHEN Yupeng;KANG Zhuo(Nankai University,Tianjin,China)
出处
《经济学动态》
CSSCI
北大核心
2023年第9期111-130,共20页
Economic Perspectives
基金
首都医科大学国家医疗保障研究院开放性课题“长期护理保险经济社会效应研究”(YB2022B06)
天津市研究生科研创新项目“新时代相对贫困治理视角下长期护理保险运行机制与保障效果研究”(2021YJSB059)。
关键词
失能风险
长期护理保险
家庭持久灾难性卫生支出
正外部性
健康福利
Disability Risk
Long-term Care Insurance
Household Persistent Catastrophic Health Expenditure
Positive Externality
Health Benefits
