您的位置：山东大学 -> 科技期刊社 -> 《山东大学学报（医学版）》

山东大学学报 (医学版) ›› 2020, Vol. 58 ›› Issue (9): 89-94.doi: 10.6040/j.issn.1671-7554.0.2020.0680

• • 上一篇    下一篇

山东省三地家庭卫生筹资公平性探讨

范嘉音1,2,赵迪1,2,郭磊1,2,贾莉英1,2   

  1. 1. 山东大学齐鲁医学院公共卫生学院卫生管理与政策研究中心, 山东 济南 250012;2. 国家卫生健康委员会卫生经济与政策研究重点实验室(山东大学), 山东 济南 250012
  • 出版日期:2020-09-10 发布日期:2020-08-30
  • 通讯作者: 贾莉英. E-mail:lyjia@sdu.edu.cn
  • 基金资助:
    山东省社会科学规划研究(18CZKJ22)

Health financing fairness of households in three regions of Shandong Province

FAN Jiayin1,2, ZHAO Di1,2, GUO Lei1,2, JIA Liying1,2   

  1. 1. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. NHC Key Lab of Health Economics and Policy Research(Shandong University), Jinan 250012, Shandong, China
  • Online:2020-09-10 Published:2020-08-30

PDF (PC)

140

摘要： 目的 在医保一体化背景下,探讨家庭卫生筹资公平性差异及影响公平性的因素,并提出相关建议。 方法 对山东省齐河、济阳和即墨的城乡居民入户调查获取数据,利用泰尔指数、基尼系数、集中系数和Kakwani指数进行公平性评价,并通过单因素卡方检验和多因素有序Logistic回归模型对其影响因素分析。 结果 三地城乡之间家庭卫生筹资公平性存在一定差距,城市(Kakwani指数=0.32)优于农村(Kakwani指数=0.20),地区、性别、年龄、婚姻状况、文化程度、工作状况可能是相关影响因素。 结论 医保一体化能够缩小城乡差距,统一医保待遇,因此可以进一步深化该项政策,保障卫生筹资公平性。

关键词: 医保, 一体化, 卫生筹资, 公平性, 影响因素

Abstract: Objective To explore the differences in health financing fairness of households and the influencing factors in the context of medical insurance integration, and to put forward relevant recommendations. Methods Urban and rural households in Qihe, Jiyang, and Jimo of Shandong Province were interviewed, and the health financing fairness was evaluated with the Theil index, Gini coefficient, concentration coefficient and Kakwani index. The influencing factors were determined with single-factor chi-square test and multivariate ordered Logistic regression analysis. Results There was a gap in health financing fairness between urban and rural households in the three regions, and urban households had higher health financing fairness than rural households(Kakwani index: 0.32 vs 0.20). Region, gender, age, marital status, educational level and work status were the influencing factors. Conclusion The medical insurance integration can narrow the urban-rural gap and unify medical benefits, so this policy can be further deepened to ensure the fairness of health financing.

Key words: Medical insurance, Integration, Health financing, Fairness, Influencing factor

中图分类号: 

  • R197.1
[1] 李赖志, 汪红奎. 基于城乡一体的医疗保险社会化问题研究[J]. 黑河学刊, 2008, 24(6): 142-144.
[2] 田闻笛. 从“碎片化”走向“一体化”: 中国城乡医疗保险制度改革进路[J].河南社会科学, 2019, 27(5): 103-107. TIAN Wendi. From “Fragmentation” to “Integration”: Chinas urban and rural medical insurance system reform path[J]. Henan Social Sciences, 2019, 27(5): 103-107.
[3] 国务院关于印发“十二五”期间深化医药卫生体制改革规划暨实施方案的通知[EB/OL].(2012-03-21)[2020-03-20]. http://www.gov.cn/zwgk/2012-03/21/content-2096671.htm.
[4] 山东省人民政府关于建立居民基本医疗保险制度的意见[EB/OL].(2013-12-31)[2020-03-20]. http://www.shandong.gov.cn/art/2013/12/31/art-2267-18052.html.
[5] 李超凡. 山东省城乡居民基本医疗保险制度的公平性研究[D]. 济南: 山东大学, 2018.
[6] 高颖, 李丽清. 我国卫生筹资公平性的泰尔系数分析[J]. 中国卫生统计, 2018, 35(4): 600-602.
[7] 卢建龙, 徐晓程, 张倩, 等. 卫生筹资公平性研究方法综述[J].中国卫生资源, 2012, 15(4): 302-305. LU Jianlong, XU Xiaocheng, ZHANG Qian, et al. Review of methodology of health financing equity [J]. Chinese Health Resource, 2012, 15(4): 302-305.
[8] 朱凯. 不同类型数据下基尼系数的计算方法[J].内江科技, 2018, 39(9): 43-44.
[9] 郭清, 王小合, 李晓惠, 等. Lorenz曲线和Gini系数在社区卫生服务资源配置公平性评价中的应用[J]. 中国卫生经济, 2006, 25(1): 50-53. GUO Qing, WANG Xiaohe, LI Xiaohui, et al. The Lorenz curve, Gini coefficient and their application study on fairness of resource allocation for community health services [J]. Chinese Health Economics, 2006, 25(1): 50-53.
[10] 郝义彬, 李众, 马婧, 等. 深圳市卫生资源配置公平性与效率分析[J]. 医学与社会, 2019, 32(12): 44-47. HAO Yibin, LI Zhong, MA Jing, et al. Equity and efficiency analysis of health resources allocation in Shenzhen [J]. Medicine and Society, 2019, 32(12): 44-47.
[11] 李晓惠. 社区卫生服务资源配置评价方法研究[J]. 中国卫生统计, 2006, 23(3): 215-217. LI Xiaohui. Evaluation method studies on equity of resources allocation for community health services in living areas [J]. Chinese Journal of Health Statistics, 2006, 23(3): 215-217.
[12] 周明华, 肖政. 我国卫生资源配置状况及公平性分析[J].中国社会医学杂志, 2019, 36(2): 193-196. ZHOU Minghua, XIAO Zheng. Analysis of the condition and fairness of health resources allocation in China [J]. Chinese Journal of Social Medicine, 2019, 36(2): 193-196.
[13] 中共中央国务院印发《“健康中国2030”规划纲要》[EB/OL].(2016-10-25)[2020-03-20]. http://www.gov.cn/xinwen/2016-10/25/content-5124174.htm.
[14] Harrison DA, Klein KJ. Whats the difference? Diversity constructs as separation, variety, or disparity in organizations [J]. Academy of Management Review, 2007, 32(4): 1199-1228.
[15] Trevor CO, Wazeter DL. A contingent view of reactions to objective pay conditions: interdependence among pay structure characteristics and pay relative to internal and external referents [J]. J Appl Psychol, 2006, 91(6): 1260-1275.
[16] Christie AM, Barling J. Beyond status: relating status inequality to performance and health in teams [J]. J Appl Psychol, 2010, 95(5): 920-934.
[17] Daniel S, Agarwal R, Stewart KJ. The effects of diversity in global, distributed collectives: a study of open source project success [J]. Information Systems Research, 2013, 24(2): 312-333.
[18] Curseu PL, Sari K. The effects of gender variety and power disparity on group cognitive complexity in collaborative learning groups [J]. Interactive Learning Environments, 2015, 23(4): 425-436.
[19] 颜节礼, 王祖祥. 洛伦兹曲线模型研究综述和最新进展[J]. 统计与决策, 2014, 25(1): 34-39.
[20] 孙振球. 医学统计学[M]. 北京:人民卫生出版社, 2014.
[21] 黎东生, 伍珏, 龙文磊, 等. 基于泰尔指数的广东省三市医疗保险基金公平性分析[J]. 现代医院管理, 2017, 15(6): 49-51. LI Dongsheng, WU Jue, LONG Wenlei, et al. Analysis on the equity of medical insurance fund in the three cities of Guangdong province based on Theil index [J]. Modern Hospital Management, 2017, 15(6): 49-51.
[22] 徐伟, 许正圆. 城镇居民基本医保筹资公平性评价[J]. 卫生经济研究, 2015, 18(10): 30-32. XU Wei, XU Zhengyuan. Financing fairness evaluation of basic medical insurance for urban residents [J]. Health Economics Research, 2015, 18(10): 30-32.
[23] 应晓华, 刘宝, 胡善联, 等. 不同收入人群家庭筹资公平性研究[J]. 中华医院管理杂志, 2004, 20(8): 12-15.
[24] 陈晓彤. 城市外来劳动力与城市居民收入影响因素对比探究——基于CHIP微观横截面数据分析[J].湖北民族学院学报(自然科学版), 2012, 30(4): 469-472. CHEN Xiaotong. A comparative analysis of income influence factors between urban residents and migratory workers——based on the CHIP cross-ection data [J]. Journal of Hubei Minzu University(Natural Science Edition), 2012, 30(4): 469-472.
[25] 陈迅, 孙成东. 城乡内部引起收入差距主要因素的对比分析——以山东省为例[J]. 技术经济, 2011, 30(1): 95-98. CHEN Xun, SUN Chengdong. Comparative analysis on main influencement factor of rural and urban income gap:a case of Shandong province [J]. Technology Economics, 2011, 30(1): 95-98.
[26] 穆红梅. 城镇化水平与城乡收入差距关系研究——基于收入结构视角[J]. 经济问题, 2019, 12(8): 112-120. MU Hongmei. Urbanization and the income gap between urban and rural areas based on income structure perspective[J]. On Economic Problems, 2019, 12(8): 112-120.
[27] 赵昕东, 李林. 家庭经济因素和人口特征如何影响不同收入等级城镇居民消费[J]. 数理统计与管理, 2016, 35(6): 1076-1085. ZHAO Xindong, LI Lin. How economic and demographic factors influence the consumption of urban residents of different income levels [J]. Journal of Applied Statistics and Management, 2016, 35(6): 1076-1085.
[1] 姜小峰,姚静静,朱大伟,何平,石学峰,孟庆跃. 补偿机制改革对山东省某县级公立医院住院服务的影响[J]. 山东大学学报 (医学版), 2020, 58(9): 95-102.
[2] 张娟,张璐嘉,肖伟,李顺平. 住院医师规范化培训学员压力知觉与留职意愿及影响因素[J]. 山东大学学报 (医学版), 2020, 58(7): 108-114.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
版权所有 © 2018 《山东大学学报(医学版)》编辑部　
地址:山东大学科技期刊社（济南市历城区山大南路27号山东大学中心校区明德楼B座721室） 电话: 0531-88366918 E-mail: xbyxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发