政策体验效用驱动城乡居民主动参保行为的理论内涵与政策启示

许兴龙; 卢利

doi:10.19546/j.issn.1674-3830.2026.3.007

中国医疗保险 ›› 2026, Vol. 0 ›› Issue (3) : 57-64. DOI: 10.19546/j.issn.1674-3830.2026.3.007

观察思考

政策体验效用驱动城乡居民主动参保行为的理论内涵与政策启示

许兴龙, 卢利

作者信息 +

Theoretical Implications and Policy Insights: Policy Experience Utility-Driven Urban and Rural Residents' Proactive Insurance Enrollment Behavior

Author information +

文章历史 +

摘要

在城乡居民基本医疗保险自愿参保的背景下，引导居民主动、持续参保是制度可持续发展的着力点之一。本文引入“政策体验效用” 这一行为经济学概念，并将其界定为居民在参保全周期中形成的，涵盖过程、服务、结果及情感信任的四维综合感受。基于对贵州、云南等地的实地调研与半结构化访谈，融合前景理论中的“损失厌恶”与“心理账户”原理，构建了一个整合性的理论分析框架。该框架阐释了政策设计如何系统性塑造居民的正向体验效用，影响其风险感知与价值判断，从而驱动其主动参保行为的内在逻辑。在此基础上，研究进一步提炼出通过政策激励、组织协调、主体互动与规范塑造等多重路径，系统性优化居民的政策体验，最终构建一个融合精准靶向、多方协同、价值感知重塑与健康诉求导向的长效驱动机制。

Abstract

Under the voluntary enrollment policy for basic medical insurance for urban and rural residents, motivating sustained proactive participation is crucial for the system’s sustainability. This study introduces the behavioral economics concept of “policy experience utility”, defining it as a four-dimensional comprehensive perception encompassing process, service, outcome, and emotional trust throughout the enrollment cycle. Based on field research and semi-structured interviews in regions such as Guizhou Province and Yunnan Province, and integrating the principles of “loss aversion” and “mental accounting” from prospect theory, this paper constructs an integrative analytical framework. This framework elucidates the internal logic of how policy design drives proactive enrollment behavior by systematically shaping residents’ positive experience utility, thereby influencing their risk perception and value judgment. On this basis, the study identifies multiple pathways—policy incentives, organizational coordination, stakeholder interaction, and norm shaping—to systematically optimize the policy experience of residents, ultimately aiming to establish a long-term driving mechanism characterized by precise targeting, multi-party collaboration, value perception reshaping, and health demand orientation.

导出引用

许兴龙, 卢利. 政策体验效用驱动城乡居民主动参保行为的理论内涵与政策启示[J]. 中国医疗保险. 2026, 0(3): 57-64 https://doi.org/10.19546/j.issn.1674-3830.2026.3.007

Theoretical Implications and Policy Insights: Policy Experience Utility-Driven Urban and Rural Residents' Proactive Insurance Enrollment Behavior[J]. China Health Insurance. 2026, 0(3): 57-64 https://doi.org/10.19546/j.issn.1674-3830.2026.3.007

中图分类号： F840.684 C913.7

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基金

国家自然科学基金面上项目“基于政策体验效用的城乡居民主动参保行为驱动路径与长效机制研究”（72574086）；国家自然科学基金面上项目“基于居民主动利用的基层卫生服务价值实现机制与提升策略研究”（72274081）；江苏省社科基金项目“多病共存背景下数智赋能江苏基层医防融合的机制与政策研究”（24GLB023）。