[1]顾海,马超,吉黎.医疗领域的城乡差距与城乡不公正——以门诊患者为例[J].南京农业大学学报(社科版),2015,15(04):53-61.
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医疗领域的城乡差距与城乡不公正——以门诊患者为例()
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南京农业大学学报（社科版）[ISSN:1006-6977/CN:61-1281/TN]

卷:
15
期数:
2015年04期
页码:
53-61
栏目:
农民生计与保障
出版日期:
2015-07-31

文章信息/Info

Title:
Disparities and Inequity in Urban-Rural Health Care:Illustrated by the Example of Outpatients
作者:
顾海1;  马超2;  吉黎3
1. 南京大学公共卫生管理与医疗保障政策研究中心, 江苏南京 210093;
2. 东南大学公共卫生学院, 江苏南京 210009;
3. 上海理工大学管理学院, 上海 200093
关键词:
城乡差距; 城乡不公正; 医疗支出; 倾向值
分类号:
F840.684
摘要:
医疗领域的城乡差距并不能代表城乡不公正的观点,后者才是更有价值更值得关注的话题。文章利用倾向值加权方法双稳健的优良特性,计算了城乡门诊医疗的实质不公正,并与传统的O-B分解进行对比。使用CHNS2009年截面数据进行实证分析,研究表明:对数门诊支出的平均处理效应ATE和处理组平均处理效应ATT,分别为0.556和0.519,以此作为对门诊医疗支出城乡不公正的度量,他们占城乡差异的比重分别为64.0%和68.6%。结合O-B分解的结论,城乡门诊差异中有60%~90%属于城乡不公正。文章认为,政策制定者应将焦点由"城乡差异"逐步转向"城乡不公正",应逐步拉平城乡居民的补偿待遇,并通过适当的累进性的筹资机制,缓解因城乡收入差距过大而造成的不公正。同时,还应大力推进城乡医疗资源均等化,从而逐步消弭医疗领域的城乡差距。
Abstract:
This paper firstly reviewed the previous studies on the equity in the field of public health, and proposed that the rural-urban disparity cannot represent the rural-urban inequity, and the latter is a topic of value and attention-worth. This paper used the cross-section data of CHNS2009 and adopted weighting propensity score method with double stability to measure the urban-rural disparities of public health in outpatients and made a comparison at the same time with the traditional O-B decomposition. Our researches showed that: the average treatment effect ATE and the average treatment effect of the treated ATT of the log outpatient expenditure were 0.556 and 0.519 respectively, accounting for about 64.0% and 68.6% of the urban-rural differences. About 60% ~90% of the urban-rural differences can be attributed to the urban-rural disparities combined with the conclusion of O-B decomposition. According to this paper, the focus of the policy maker should be converted from urban-rural differences to urban-rural inequalities, the remuneration should be equaled, and the government should also set the progressive financing mechanism in order to remit the inequity due to the income gap between urban and rural. Meanwhile, the government is supposed to promote the equalization of urban and rural health resources to eliminate the urban-rural disparities gradually.

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备注/Memo

备注/Memo:
收稿日期:2014-9-21;改回日期:。
基金项目:国家自然科学基金项目"统筹城乡医疗保障制度对城乡居民健康及医疗利用的影响研究——基于自然实验框架下的分析"(71373120)
作者简介:顾海,男,南京大学公共卫生管理与医疗保障政策研究中心主任,南京大学政府管理学院教授、博士生导师,主要研究方向为健康经济与社会保障。E-mail:ghai1008@sina.vip.com; 马超,男,东南大学公共卫生学院讲师,博士,研究方向为微观应用计量、健康经济学与社会保障。 吉黎,女,上海理工大学管理学院讲师,博士,研究方向为劳动经济学。
更新日期/Last Update: 1900-01-01