【摘要】 《"健康中国2030"规划纲要》明确提出突出解决好重点人群的健康问题,建立成熟、定型的全民医疗保险体系。比较城镇基本医疗保险制度对参保居民健康相关生命质量的影响,对于完善城市基本医疗保障制度、进一步提高卫生服务可及性、实现"全民健康"具有重要意义。研究采用2013年陕西省第五次国家卫生服务调查数据,首次采用广义精确匹配法(CEM)控制混杂因素对评估结果的影响。研究基于我国的EQ-5D效应值积分体系计算EQ-5D健康效应值,采用集中指数法、集中指数分解法等方法分别计算参保居民和未参保居民健康相关生命质量的公平性。研究结果显示,城镇职工基本医疗保险显著提高了参保居民的健康相关生命质量,而城镇居民基本医疗保险的影响并不显著;其次,城镇职工基本医疗保险显著提高了参保居民的健康相关生命质量公平性,而城镇居民基本医疗保险的影响并不显著;最后,健康相关生命质量不平等性主要由年龄、教育程度、人均消费性支出等变量解释,参保居民的水平公平性均大于未参保居民。更多还原

【Abstract】 To highlight the solution of the health issues for focus groups and to establish a mature and formed universal medical insurance system are clearly put forward in The Plan for a Healthy China 2030.It is of great significance for the perfection of the basic medical insurance system in urban areas,the further improvement of the accessibility of health services and the realization of"Health for All"to compare the influence of basic medical insurance system on the insured resident’s health-related quality of life.According to the data of the fifth national health service survey of Shaanxi Province in 2013,the study controls the effect of the confounders on evaluating results by the first adoption of the method of coarsened exact matching(CEM).Based on calculating the EQ-5D health effect value by the integral system of EQ-5D effect value in China,this study calculates the fairness of the level of the insured resident’s health-related quality of life and the fairness of the level of the uninsured resident’s health-related quality of life respectively by the method of concentration index and the method of the decomposition of concentration index.The study results show that:1)the basic medical insurance for urban workers has significantly improved the insured resident’s health-related quality of life,on which,however,the effect of basic medical insurance for urban residents is not significant;2)the basic medical insurance for urban workers has significantly improved the fairness of the insured resident’s health-related quality of life,on which,however,the effect of basic medical insurance for urban residents is not significant;3)the inequality of health-related quality of life is mainly explained by the variables of age,degree of education,per capita consumption expenditure,etc.,while the fairness of the level of the insured residents is greater than the one of the uninsured residents.更多还原