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健康中国战略下的健康行为与医疗保险:道德风险视角

Health behavior and medical insurance under the healthy China strategy: a moral hazard perspective.

作者信息

Chen Linhong, Zhang Lingyu, Xu Xiaocang

机构信息

School of Marxism, Chongqing Technology and Business University, Chongqing, China.

School of Economics and Management, Huzhou University, Huzhou, China.

出版信息

Front Public Health. 2024 Dec 13;12:1315153. doi: 10.3389/fpubh.2024.1315153. eCollection 2024.

Abstract

INTRODUCTION

High medical expenditure is one of the major obstacles to achieving common prosperity in China. As a health risk compensation and protection mechanism, medical insurance has played a good role in alleviating the economic burden of patients. However, due to the existence of moral hazard, medical insurance may also lead to the occurrence of psychological deviation and overtreatment of patients or hospitals' health treatment expectations, thus generating unnecessary pressure on public financial expenditure.

METHODS

Using the China Health and Retirement Longitudinal Survey (CHARLS) and Heckman model, this paper discusses the difference in the impact of medical insurance on outpatient and hospitalization costs. The change of the proportion of out-of-pocket medical expenditure is further analyzed.

RESULTS

The study found that while medical insurance reduced the probability of outpatient visits and increased the probability of hospitalization, it increased the cost of outpatient visits and hospitalization. Further, it reduces the share of out-of-pocket medical expenditure.

DISCUSSION

This shows that medical insurance does play a role in alleviating the financial pressure of patients, but the overtreatment caused by moral hazard cannot be ignored, especially the over-examination and over-prescribing of drugs in the outpatient process.

摘要

引言

高额医疗支出是中国实现共同富裕的主要障碍之一。医疗保险作为一种健康风险补偿和保护机制,在减轻患者经济负担方面发挥了良好作用。然而,由于道德风险的存在,医疗保险也可能导致患者或医院的健康治疗期望出现心理偏差和过度治疗,从而给公共财政支出带来不必要的压力。

方法

本文利用中国健康与养老追踪调查(CHARLS)和赫克曼模型,探讨医疗保险对门诊和住院费用影响的差异。进一步分析了自费医疗支出比例的变化。

结果

研究发现,医疗保险虽然降低了门诊就诊概率,提高了住院概率,但却增加了门诊和住院费用。此外,它降低了自费医疗支出的比例。

讨论

这表明医疗保险在减轻患者经济压力方面确实发挥了作用,但道德风险导致的过度治疗不容忽视,尤其是门诊过程中的过度检查和过度开药。

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