【作者】 刘国恩； 蔡仁华； 熊先军； 赵忠云；

【Author】 GORDON G.LIU, (University of North Carolina at Chapel Hill and Peking University Guanghua School of Management) RENHUA CAI, (China National Institute of Health Economics) Xianjun Xiong (China Ministry of Labor and Social Security) Zhongyun Zhao, (Eli Lilly & Company,USA)

【机构】 美国北卡大学； 北京大学光华管理学院； 卫生部卫生经济研究所； 劳动与社会保障部； Health Outcomes Research,Eli Lilly & Company,USA；

【摘要】 利用1994-1996年的镇江改革试点调查,该研究首次提供了实证数据,用以量化中国城市医疗保险改革如何影响不同社会经济和健康人群间的个人自付支出的分配。研究主要结论显示,虽然自付支出及其相对变量在改革后对普遍人群都有所增加,但处于低等社会经济和健康状况的弱势人群的相对受益更大,这在自付支出总量模型、自付支出占总成本和占总收入比例模型中都获得一致和显著的证据。该研究的结论是,中国以城市为基本单位的医疗保险改革模式在控制医疗成本和扩大保险人群的前提下,也能有效地提高个人成本分担的公平性。更多还原

【Abstract】 Using the 1994-96 survey data from the Zhenjiang pilot experiment,this study presents the first empirical evidence on the impact of China’s urban insurance reform on the distribution of out-of-pocket(OOP) expenditures across four representative groups defined by income,education,job status,and chronic disease conditions.Major findings are as follows. While the reform increased OOP expenditures modestly for all groups,strong evidence suggest the reform to be more equitable in favor of the disadvantaged groups,in terms of total OOP payment,OOP share of total health expenditures,and OOP share of income.This study concludes that the new community-based insurance program leads to equity improvement in cost sharing while containing cost inflation and extending basic insurance coverage for the urban employed population in China.更多还原