新农合对农村老年人医疗服务利用的影响——基于高龄、低龄老人分析

运用中国营养与健康调查数据(CHNS),实证分析了新农合对农村高龄和低龄老年人医疗服务利用的影响,从老年人群年龄异质性的角度,对新农合的实施绩效进行了重新考察。研究发现,与新农合实施前的2000年相比,新农合全面普及的2011年农村低龄老年患者的就医率增加了9.45%,而高龄老人的就医率却下降了13.38%;计量模型表明,新农合显著增加了低龄老人的医疗服务利用水平和预防保健支出,但对高龄老人的影响不显著。这表明经济因素可能仍是我国农村高龄老人医疗可及性的制约因素,新农合政策提高农村最脆弱群体医疗可及性的作用不明显。因此,政府应继续完善农村医保政策,关注农村最脆弱群体,以增加对农村高龄老人患病时的经济保护。

The effect of new rural cooperative medical system on the health service utilization in rural elderly: Based on analysis among elderly and younger aged people

We used data from China Nutrition and Health Survey (CHNS) to empirically analyze the effect of new rural cooperative medical system (NRCMS) on health service utilization in rural elderly and younger aged people. From the perspective of age heterogeneity of the elderly, this paper has re-investigated the implementation performance of NRCMS.The study found that rate of medical care in rural younger aged patients increased by 9.45% in 2011 compared to the percentage we had in 2000. In contrast, this index for the elderly dropped by 13.38% for the same concern. The econometric model showed that the NRCMS has significantly increased the consumption of medical services and preventive healthcare for rural younger aged people, but this impact is not significant when effected on elderly. It indicated that NRCMS policy is not obvious in improving medical accessibility factor for the most vulnerable groups and economic factors may still be limiting the access to medical services for the rural elderly in China. Therefore, the government should continue to improve the NRCMS policy to focus on most vulnerable groups in rural areas in order to increase financial protection for the rural elderly which is the most vulnerable group on health and economy in rural China, especially when the fall sick.