中国农民医疗消费行为变化及其政策含义.pdfVIP

中国农民医疗消费行为变化及其政策含义 封 进 秦 蓓 （复旦大学就业与社会保障研究中心） 摘要：本文采用CHNS数据，用一个医疗决策模型和医疗支出模型估计了中国农 民的医疗支出和收入水平之间的关系。在收入的直接效应作用下，收入水平与医疗 支出成正比,在收入的间接效应作用下，收入水平与医疗支出呈反比，因此通常观 测到的二者之间的关系是两种效应的综合。结果表明在1989年，收入水平和医疗支 出呈反比，收入的间接效应大于直接效应。到1997年，收入水平对医疗支出的影响 变得不显著。究其原因，这一时期的收入的直接效应和间接效应均发生作用且作用 相当。这种情形下的低收入农民面临收入的直接效应和间接效应的双重影响，其结 果可能是低收入的农民贫困程度进一步加深和健康水平进一步下降。因此，随着市 场化程度的提高，改善农村医疗设施，提高医疗服务的可及性，增加对低收入农民 的转移支付，建立医疗保障制度的必要性更加突出。 Consumption of Medical Care in Rural China Feng Jin Qin Bei (Fudan University) Abstract: We use CHNS data and employ a medical choice model and a medical expenditure model to estimate the relationship between income and medical expenditure in rural China. Medical expenditure decreases with the income due to the health effect, while it increases with the income due to the income effect. So the observed relationship between medical expenditure and income is determined by the net effect. Our results show that in 1989, medical expenditure was increasing with income, which implied the health effect outweighed the income effect. In year 1997, the relationship became insignificant. We show that both of the two effects were strong and balanced. In such case, the lower income farmers will have more medical burden because of the health effect and their purchasing power for medical service will be lower because of income effect. Thus the poverty and health status of the lower income farmers might be worse. So it is important to improve the medical facility in rural area, increase the transfer payment to lower income farmers and establish rural medial care system. This document was created with the trial version of Print2PDF!