| 引用本文：姚强, 陈阿敏.医疗保险参保地对老年流动人口健康状况的影响路径研究——基于2015年全国流动人口动态监测调查数据[J].中国卫生政策研究,2022,15(1):57-63 |
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| 医疗保险参保地对老年流动人口健康状况的影响路径研究——基于2015年全国流动人口动态监测调查数据 |
| 投稿时间：2021-11-15 修订日期：2022-01-05 PDF全文浏览 HTML全文浏览 |
| 姚强1,2, 陈阿敏1 |
1. 武汉大学政治与公共管理学院 湖北武汉 430072;
2. 武汉大学社会保障研究中心 湖北武汉 430072 |
| 摘要:目的： 探析医疗保险参保地点对我国老年流动人口健康状况的影响及路径。方法： 利用2015年全国流动人口动态监测调查数据，基于安德森卫生服务利用行为模型，运用路径分析方法，分析医疗保险参保地点对健康状况的影响及路径。结果： 在居住地参保有利于流动老人参加健康体检(β=0.60, P<0.001)、小病就医(β=0.33, P<0.001)；同时，参加健康体检(β=0.40,P=0.001)和小病就医(β=0.23,P<0.05)对流动老人的健康状况有正向作用。对于患慢性病的流动老人而言，参保地点除了可以通过“健康体检”和“小病就医”两条路径，还可以通过“慢性病随访”、“慢性病随访—健康体检”和“慢性病随访—小病就医”三条路径影响其健康状况。结论： 医疗保险参保地点通过卫生服务利用多维路径影响老年流动人口的健康状况，建议通过提高医保统筹层次、消除医疗保险转移接续和异地就医直接结算障碍，同时关注医疗和公共卫生服务内容等方面，减少流动人口参保地和居住地分离而导致的健康不平等问题。 |
| 关键词:流动人口 医疗保险 参保地点 自评健康 健康不平等 |
| 基金项目:国家自然科学基金面上项目(72174149)；国家自然科学基金青年项目(71603188)；教育部人文社会科学研究规划基金项目(21YJAZH102)；教育部人文社会科学研究青年基金项目(16YJCZH137) |
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| Influencing paths of medical insurance enrollment location on the health conditions of elderly migrants in China: Based on data from 2015 China Migrants Dynamic Survey |
| YAO Qiang1,2, CHEN A-min1 |
1. School of Political Science and Public Administration, Wuhan University, Wuhan Hubei 430072, China;
2. Center for Social Security Studies, Wuhan University, Wuhan Hubei 430072, China |
| Abstract:To investigate the influence and influencing paths of medical insurance enrollment location on the health conditions of the elderly migrants in China.Methods: Using data from the 2015 China Migrants Dynamic Survey, and based on the Anderson health service utilization model, we used the path analysis method to assess the influence and influencing paths of medical insurance enrollment location on people's health conditions. Results: Having local health insurance coverage allowed migrants to more easily have physical examinations (β=0.60;P<0.001) and see a doctor forminor sickness (β=0.33; P<0.001). Meanwhile, having physical examinations (β=0.40;P=0.001) and doctor visits forminor sickness (β=0.23;P<0.05) had positive effects on the health conditions of elderly migrants. For elderly migrants with chronic diseases, the medical insurance enrollment location can affect their health conditions also via several other paths than “physical examination” and “doctor visit for minor sickness”, which included“chronic disease follow-up”, “chronic disease follow-up-health examination” and “chronic disease follow-up-doctor visit”. Conclusions: The medical insurance enrollment location affected the health conditions of elderly migrants through health services via multiple dimensions of paths. It is suggested that the government should improve the overall planning level of medical insurance, eliminate the obstacles of medical insurance transfer and on-spot settlements of medical bills in places away from one's hometown, and pay attention to both medical and public healthcare service contents, so as to reduce the health inequality of migrants caused by the inconsistency of medical insurance enrollment location and residence location. |
| Key words:Migrant Medical insurance Medical insurance enrollment location Self-evaluated health conditions Health inequalities |
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