中国农村合作医疗的受益公平性

在中国的大多数地区所建立的合作医疗都属于“低保费、高共付率”的形式。虽然低保费更有利于贫困的农民参加合作医疗,但是,高共付率会阻碍他们实际利用医疗服务。利用2002年中国贵州省开阳县冯三镇的家庭入户调查资料,采用logistic回归模型和“四部模型”研究农民参加合作医疗的概率、合作医疗参加者对卫生服务的利用、以及农民从合作医疗获得的净收益,探索这种“低保费、高共付率”设计的合作医疗的受益公平性。结果表明,在“低保费、高共付率”模式下,合作医疗受益存在着不公平性。基于研究结果提出了政策性建议。

The Public Benefit Equity of Pural Cooperative Medical Scheme in China

Most China's cooperative medical systems(CMS)require low premiums but high co-payments.While lowpremium CMS's are more affordable to poor farmers,high co-payments may assret significant deterring effects on the poor in use of service.The objective of this study was to investigate the equity in net benefits(NB)in CMS's with low premium and high-co-payment benefit design.A household survey was administered in China Fengshan Township.The probability of farmer participation in the reestablished CMS was estimated using logistic regression,and a "Four-Part"model was used to analyze CMS participants' utilization of health services.The NB was estimated based on the probability of participation and the utilization of health services.The results showed there is a significant inequity in NB in this type of CMS.Policy recommendations were made based on the results from this study.