健康保险对农村老年人口贫困的影响：来自中国西部九个县的证据。
The impact of health insurance on poverty among rural older adults: an evidence from nine counties of western China.
机构信息
School of Public Administration, Northwest University, 1 Xuefu Road, Chang' an District, Xi' an, 710127, Shaanxi, China.
Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, ON, M5T 3M6, Canada.
出版信息
Int J Equity Health. 2021 Jan 25;20(1):47. doi: 10.1186/s12939-021-01379-5.
BACKGROUND
Older adults are more prone to various diseases. Health insurance becomes effective mechanism to relieve financial burden when the insured is sick. In China, most older adults live in the countryside, and New Rural Cooperative Medical Scheme is a kind of health insurance system in rural areas. The relationship between New Rural Cooperative Medical Scheme and financial burden due to health expenditure of older adults in China was investigated. This paper aims at the impact of New Rural Cooperative Medical Scheme on the poverty among rural older adults.
METHODS
This study employs Probit model and Tobit model to assess the impact of New Rural Cooperative Medical Scheme on alleviating poverty among rural older adults based on a survey in nine representative counties in western China.
RESULTS
The findings show that diseases have significantly negative impact on rural elderly poverty. New Rural Cooperative Medical Scheme has impact on alleviating of the health-payment poverty due to catastrophic health expenditure, but the impact is limited. The impact of health insurance on poverty alleviation is greater for men, older adults aged between 60 to 69 and households in in economically poorer area than their counterparts.
CONCLUSIONS
This study show the relationship between New Rural Cooperative Medical Scheme and catastrophic health expenditure of older adults in China. The results draw policy attention to introduce different reimbursement expense ratios for different groups to alleviate them from poverty based on more comprehensive insurance packages.
背景
老年人更容易患上各种疾病。当被保险人患病时，健康保险成为减轻经济负担的有效机制。在中国，大多数老年人居住在农村，而新型农村合作医疗制度是农村地区的一种健康保险制度。本研究旨在调查新型农村合作医疗制度与中国农村老年人因健康支出导致的经济负担之间的关系。本文旨在探讨新型农村合作医疗制度对农村老年人贫困问题的影响。
方法
本研究采用 Probit 模型和 Tobit 模型，基于中国西部 9 个有代表性的县的调查数据，评估新型农村合作医疗制度对减轻农村老年人贫困的影响。
结果
研究结果表明，疾病对农村老年人贫困有显著的负向影响。新型农村合作医疗制度对缓解灾难性卫生支出导致的卫生支付贫困有影响，但影响有限。健康保险对男性、60 至 69 岁的老年人以及经济较贫困地区的家庭的脱贫作用大于女性、70 岁及以上的老年人以及经济较富裕地区的家庭。
结论
本研究揭示了新型农村合作医疗制度与中国老年人灾难性卫生支出之间的关系。研究结果提请政策制定者关注，根据更全面的保险计划，为不同群体引入不同的报销费用比例，以帮助他们摆脱贫困。
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