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.
Key words
basic medical insurance /
frontier residents /
sense of security
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References
[1] 新华社.政府工作报告[EB/OL].(2025-03-05)[2025-12-24]. https://www.gov.cn/yaowen/liebiao/202503/content_7013163.htm.
[2] 国家医疗保障局. 2024年全国医疗保障事业发展统计公报[EB/OL]. (2025-07-14)[2025-08-24].https://www.nhsa.gov.cn/art/2025/7/14/art_7_17248.html.
[3] 况贞勇,赵翔.基本医疗保险下自付费用公平性研究[J].重庆社会科学,2024(02):101-115.
[4] 张宇微,陈家应,张兵,等.城乡居民医保整合后医疗服务利用和费用负担变化研究[J].卫生经济研究,2022,39(07):32-36.
[5] 李乐乐,王曦.城乡居民基本医疗保险门诊统筹对慢性病患者健康水平的影响机制分析[J].保险研究,2024(08):100-112.
[6] 李聪,冯雪婷,吕学梁.多层次医疗保障体系与居民家庭幸福感——基于中国家庭金融调查数据的分析[J].中国经济问题,2024(05):180-196.
[7] 王昭茜. 从分级治理到央地协同:基本医疗保险地区差异的实践特征、影响效应与治理路径[J].社会保障评论,2024,8(06):89-105.
[8] 黄国武. 迈向共同富裕基本医疗保险适度水平研究:内涵、测评与路径[J].社会保障评论,2025,9(03):54-71.
[9] 皇甫丹霖,李芳.实施乡村振兴战略推进“美丽家园”建设[N].云南政协报,2022-03-07(004).
[10] 杨鹍飞,王冉.边疆社会健康国民心态建设:内涵、意义与路径选择[J].湖北民族学院学报(哲学社会科学版),2019,37(01):14-19+33.
[11] 弗洛伊德. 精神分析引论新编[M].高觉敷,译. 北京:商务印书馆,2009.
[12] 阿瑟·S.雷伯.心理学词典[M].李伯黍,等译.上海:上海译文出版社,1996:765-809.
[13] MASLOW A H A. Clinically derived test for measuring psychological security-insecurity[J]. Journal of general psychology, 1945, 31:21.
[14] 安东尼·吉登斯.现代性的后果[M].田禾,译.南京:译林出版社,2000.
[15] LYNCH J M, STANGE K C, DOWRICK C, et al.The sense of safety theoretical framework: a trauma-informed and healing-oriented approach for whole person care[J]. Frontiers in psychology, 2025, 15:1441493.
[16] 王俊秀,刘晓柳.现状、变化和相互关系:安全感、获得感与幸福感及其提升路径[J].江苏社会科学,2019(01):41-49+258.
[17] 阳义南,贾洪波,展凯.社会保险对劳动年龄人口“安全感”的影响研究[J].中国人口科学,2020(02):44-55+127.
[18] 青连斌. 中国民众的安全感来自哪里[J].人民论坛,2018(10):15-17.
[19] 龙莹,王健.参加医疗保险对公众安全感的影响——基于CGSS 2017数据的实证分析[J].福建农林大学学报(哲学社会科学版),2022,25(04):71-80.
[20] 康正,许金鹏,孔歆淼,等.居民医保安全感测量量表的开发与信效度检验[J].中国卫生事业管理,2023,40(08):597-600+621.
[21] 赵茜. 改制与生存:新疆生产建设兵团社会保障制度研究[D].北京:中央民族大学,2009.
[22] 代荣艳. 金平县农村社会保险费征缴管理研究[D].昆明:云南财经大学,2021.
[23] 张禧,冯荣广,陆烨.边疆农场职工医疗保险制度实施现状的研究——以勐腊县农场为例[J].上海保险,2024(08):49-55.
[24] 中国银行保险报.《消费者金融健康——从理念倡导到实践探索》发布[EB/OL].(2024-04-29)[2025-08-24].http://www.cbimc.cn/content/2024-04/29/content_515918.html.
[25] 刘畅. 多层次社会资本和医疗保险对内蒙古城乡居民健康水平的影响[J].江苏卫生事业管理,2025,36(09):1282-1286.
[26] 中国保险行业协会.中国中老年人风险保障研究[R/OL]. (2024-03-20)[2025-08-24].https://www.iachina.cn/art/2024/3/20/art_44_107536.html.
[27] 英洁,姚琛.健康老龄化视角下的健康行为研究:问题、成因及促进策略[J].云南民族大学学报(哲学社会科学版),2025,42(02):65-73.
[28] 丛中,安莉娟.安全感量表的初步编制及信度、效度检验[J].中国心理卫生杂志,2004 (02):97-99.
[29] 桑林. 社会医疗保险对居民幸福感的影响及内在机制研究[J].社会保障研究,2018(06):31-45.
[30] 余变玲. 基本医疗保险对幸福感的影响分析及实证研究[D].哈尔滨:哈尔滨工业大学,2021.
[31] COLEMAN J S.Foundations of social theory[M]. Cambridge: Belknap Press of Harvard University Press, 1990.
[32] WILKINSON R D, PICKETT K E.The spirit level: why more equal societies almost always do better[M]. London: Allen Lane, 2009.
[33] BRAMBOR T, CLARK R W, GOLDER M.Understanding interaction models: improving empirical analyses[J]. Political analysis, 2006, 14(1):63-82.
