| 引用本文：姚强, 张之恒, 程兆辉, 李寒旋.医疗保险视角下中国流动人口健康不平等：理论框架、水平测度与机制分析[J].中国卫生政策研究,2024,17(11):26-34 |
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| 医疗保险视角下中国流动人口健康不平等：理论框架、水平测度与机制分析 |
| 投稿时间：2024-07-16 修订日期：2024-11-10 PDF全文浏览 HTML全文浏览 |
| 姚强1,2,3, 张之恒1, 程兆辉4, 李寒旋5 |
1. 武汉大学政治与公共管理学院 湖北武汉 430072;
2. 武汉大学健康治理研究中心 湖北武汉 430072;
3. 国家医疗保障研究院华科基地 湖北武汉 430030;
4. 重庆市卫生健康统计信息中心 重庆 401120;
5. 湖北省妇幼保健院 湖北武汉 430070 |
| 摘要:目的：构建医疗保险视角下流动人口健康不平等框架并分析我国流动人口健康不平等。方法：以2017和2018年中国流动人口动态监测调查为数据源，基于Dover健康公平测量框架，通过集中指数及其分解探究医保视角下流动人口健康不平等现状及生成机制。结果：收入水平较高的流动人口，在医疗服务利用、医保服务利用和健康结果方面表现更优；医疗保险参保特征是影响流动人口医疗和医保服务利用不平等的重要因素，但其对健康结果不平等的影响较小。结论：医疗保险对流动人口健康不平等的影响呈多层次特征，医疗保险制度的社会分层效应和健康社会效应差异是导致不平等的内在机制。建议围绕筹资、待遇和经办等关键环节，多措并举提升流动人口医疗保障的公平性，缩小流动人口医疗、医保服务利用及健康结果不平等。 |
| 关键词:流动人口 医疗保险 健康不平等 集中指数 |
| 基金项目:国家自然科学基金面上项目(72174149)；国家留学基金委促进与加拿大、澳大利亚、新西兰及拉美地区科研合作与高层次人才培养项目(留金美[2023]21号)；教育部人文社会科学研究规划基金项目(21YJAZH102)；2023年武汉大学学位与研究生教育教学改革研究项目(413200122) |
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| Health inequality among migrants in China from the perspective of medical insurance: Theoretical framework, measurement and mechanism |
| YAO Qiang1,2,3, ZHANG Zhi-heng1, CHENG Zhao-hui4, LI Han-xuan5 |
1. School of Political Science and Public Administration, Wuhan University, Wuhan Hubei 430072, China;
2. Health Governance Research Center, Wuhan University, Wuhan Hubei 430072, China;
3. HUST Base of National Institute of Healthcare Security, Wuhan Hubei 430030, China;
4. Chongqing Health Statistics Information Center, Chongqing 401120, China;
5. Maternal and Child Health Hospital of Hubei Province, Wuhan Hubei 430070, China |
| Abstract:Objective: Constructing a framework to assess health inequality among migrants through the perspective of medical insurance, this study examines the inequalities and underlying mechanisms affecting China's internal migrants. Methods: Data were extracted from the 2017 and 2018 China Migrants Dynamic Survey Datasets. The health equity measurement framework developed by Dover, the concentration index and its decomposition method were used to analyse the characteristics and mechanisms of health inequality among migrants. Results: The results showed that the migrants with higher income levels performed better on medical services utilization, medical insurance services utilization, and health outcomes. Medical insurance significantly influenced the inequality in medical services utilization and medical insurance services utilization within the migrants, yet its direct effect on health outcomeswas minor. Conclusion: The impact of medical insurance on health inequality among migrants showed multi-level characteristics. The social stratification effect and the differences in health social effects of medical insurance are the internal mechanisms that lead to health inequality. It is suggested to enhance the equality of medical security of migrants through financing, benefits, and administration to reduce inequality in the medical services utilization, medical insurance services utilization, and health outcomes among China's internal migrants. |
| Key words:Migrants Medical insurance Health inequality Concentration index |
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