School of Political Science and Law, University of Jinan, Jinan, China.
School of Medical Management, Shandong First Medical University, Jinan, Shandong, China.
Front Public Health. 2023 Jan 19;10:1021435. doi: 10.3389/fpubh.2022.1021435. eCollection 2022.
The medical financial burden has become a key limitation to accessing healthcare in rural areas of China as healthcare expenses continue to rise. To ensure that low-income people have access to basic healthcare services, China has implemented medical financial assistance (MFA) policy, which provides social health insurance and medical cash assistance for low-income people.
Using data from the 2014 China Family Panel Studies (CFPS), the propensity score matching (PSM) method was applied to estimate the impact of MFA on healthcare expenses and the medical financial burden.
Empirical results showed that the total annual healthcare expenditure of MFA beneficiaries is significantly higher than that of non-beneficiaries after matching. Although low-income individuals are now covered by MFA, neither the out-of-pocket expenditure to per capita household non-food expenditure ratio nor the likelihood of catastrophic healthcare expenditure (CHE) decrease significantly.
Medical financial assistance (MFA) has reduced the inequality in healthcare utilization to a certain extent by improving access to healthcare for low-income people. However, people with low income still face a heavy medical financial burden even when they are covered by MFA. Policymakers should pay attention to raising the standards of MFA in rural areas and providing higher subsidies for the reasonable healthcare expenditures of low-income people.
随着医疗费用的不断上涨，医疗经济负担已成为中国农村地区获得医疗服务的一个主要限制因素。为确保低收入人群能够获得基本医疗服务，中国实施了医疗救助政策，为低收入人群提供社会医疗保险和医疗现金援助。
本研究利用 2014 年中国家庭追踪调查（CFPS）的数据，采用倾向评分匹配（PSM）方法估计医疗救助对医疗费用和医疗经济负担的影响。
实证结果表明，在匹配后，医疗救助受益人的年总医疗支出明显高于非受益人的年总医疗支出。尽管现在低收入者都可以享受医疗救助，但人均家庭非食品支出中自付支出的比例和灾难性医疗支出（CHE）的可能性并没有显著降低。
医疗救助通过改善低收入人群的医疗服务可及性，在一定程度上减少了医疗服务利用的不平等。然而，即使有医疗救助，低收入人群仍然面临沉重的医疗经济负担。政策制定者应关注提高农村地区医疗救助标准，为低收入人群的合理医疗支出提供更高的补贴。
