城乡居民医保整合对居民住院服务利用公平性影响及分解研究

目的]分析城乡居民医保整合对居民住院服务利用的影响。方法]以宁夏为样本省,在倾向匹配的基础上,采用集中指数及其分解法测算医保整合对住院服务利用的公平性影响,探讨影响因素。结果]低收入及中低收入组人群住院率分别从整合前的5.48%和7.01%上升到整合后的10.17%和10.50%,整合前后住院服务利用的集中指数分别为0.0765和0.0422。居民医保整合实施前后住院服务利用的不公平指数分别为0.0674和0.0620。结论]整合后公平性指数有所提高,整合后影响公平性的因素主要是经济水平、老龄化和居民的健康状况。

Study on the equity effects and decomposition of urban and rural resident medical insurance integration in hospitalization services utilization

Objective To analyze the influence of urban and rural resident medical insurance integration in hospitalization services utilization.Methods It took Ningxia as a sample province,based on the propensity score matching,the concentration index and its decomposition were used to measure the equity and influence factors of medical insurance integration in hospitalization services utilization. Results Hospitalization rate of low,low and middle income groups increased from 5. 48% and 7. 01% before integration to 10. 17% and 10. 50% after integration. The concentration index of hospitalization services utilization was 0. 0765 and 0. 0422 respectively before and after integration. The unfair index of hospitalization services utilization was 0. 0674 and 0. 0620 respectively before and after integration. Conclusions Fairness index has been improves somewhat after integration. Main influence factors of influencing fairness were economic level,aging and people’s health status.