目的:探索基本医保对边疆地区居民安全感的影响，为优化边疆地区医保政策提供依据。方法:基于2022年中国家庭追踪调查（CFPS）中边疆九省数据，本研究运用实证研究法，首先检验参加基本医保（以下简称医保参保）对边疆居民安全感的基准效应并进行稳健性检验，再从收入水平和城乡地区两方面进行异质性分析，最后引入参保状况与健康状况的交互项进行机制分析。结果:医保参保显著提升了边疆居民的安全感水平，对农村居民安全感的边际效应显著强于城镇居民，对低收入群体的安全感提升作用明显高于非低收入群体。健康状况是医保发挥安全保障功能的重要调节渠道。结论:建议在保持基本医保制度全覆盖的基础上，适度向边疆农村地区、经济脆弱群体和高健康风险人群倾斜，优化参保与支付机制、完善异地就医直接结算、强化医疗救助与基本医保衔接，提升基本医保对慢性病和高额医疗费用的保障水平，增强边疆居民对医疗风险的安全预期。
Abstract
Objective:The paper explores the impact of basic medical insurance on the sense of security among residents in frontier areas, to provide evidence for optimizing medical insurance policies in these areas. Methods:Based on data from the nine frontier provinces in the 2022 China Family Panel Studies (CFPS), this study employs empirical research methods to examine the baseline effect of basic medical insurance coverage on the sense of security among frontier residents and conduct robustness checks firstly. Then, it conducts heterogeneity analysis from two aspects: income level and urban-rural areas. Finally, it introduces an interaction term between insurance coverage status and health status for mechanism analysis. Results:Medical insurance coverage significantly enhances the sense of security among frontier residents, with a significantly stronger marginal effect on rural residents than urban residents, and a more pronounced improvement effect on low-income groups than non-low-income groups. Health status is an important moderating channel for medical insurance to exert its security function. Conclusion:It is recommended to maintain the comprehensive coverage of the basic medical insurance system, while moderately favoring rural frontier areas, economically vulnerable groups, and high health risk populations. We should optimize insurance coverage and payment mechanisms, improve direct settlement for cross-regional medical treatment, strengthen the connection between medical insurance and medical assistance, and enhance the coverage level for chronic diseases and high medical burdens by basic medical insurance, thereby enhancing the security expectations of frontier residents in the face of medical risks.
关键词
基本医保 /
边疆居民 /
安全感
Key words
basic medical insurance /
frontier residents /
sense of security
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基金
2024年度中南民族大学四部委铸牢中华民族共同体意识研究基地招标项目重点课题“中华民族共同体建设的财税路径研究”（JDZ24006）。
