本研究利用中国家庭追踪调查2016年、2018年、2020年三期平衡面板数据,采用贫困脆弱性指标识别我国城乡居民基本医疗保险参保群体因病致贫返贫的相对贫困状态,运用倾向得分匹配方法和固定效应模型评估城乡居民大病保险制度的防贫效应。研究发现：（1）在当前我国城乡居民高贫困脆弱性的现实状况下,大病保险制度整体上能够降低城乡居民的贫困脆弱性水平,但对贫困脆弱性发生率的缓解效应仍有提升空间;（2）城乡居民大病保险制度的防贫效应存在显著群体差异,中高收入群体优于低收入群体,非重大疾病患者优于重大疾病患者,加剧了“逆向再分配”现象。因此,为充分发挥制度的防贫效能,应建立针对贫困脆弱性群体的动态监测识别机制,优化大病保险制度设计,完善相应配套政策。
Abstract
With the balanced panel data of China Family Panel Studies (CFPS) in 2016, 2018 and 2020, the poverty vulnerability index was used to identify the relative poverty status of urban and rural residents' poverty caused by illness or returning to poverty due to illness, and propensity score matching (PSM) and fixed effect model was applied to evaluate the poverty prevention effect of the serious illness insurance system for urban and rural residents. The study found that under the current situation of high poverty vulnerability of urban and rural residents participating in basic medical insurance in China, the serious disease insurance system can generally reduce the poverty vulnerability level of urban and rural residents, however, there is still room for improvement in the alleviation effect of poverty vulnerability incidence. There are significant differences in poverty prevention effects of serious illness insurance system for urban and rural residents among different groups. The middle and high income groups are better than the low income groups, and the patients with non-serious diseases are better than the patients with serious diseases, which intensifies the phenomenon of reverse redistribution. In order to give full play to the poverty prevention effectiveness of the system, a dynamic monitoring and identification mechanism should be established for the groups with poverty vulnerability, the design of the serious disease insurance system should be optimized, and the construction of corresponding supporting policies should be improved.
关键词
大病保险 /
因病致贫返贫 /
贫困脆弱性 /
防贫效应
Key words
serious illness insurance system /
poverty caused by illness or returning to poverty due to illness /
poverty vulnerability /
poverty prevention effect
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基金
教育部人文社会科学研究规划基金项目“新时期因病致贫返贫风险预警及长效防控机制研究”（22YJAZH103）
