居民收入与医疗服务及其弹性研究

【作者】 叶俊；

【导师】 戚顺荣；

【作者基本信息】 复旦大学 ， 发展经济学， 2010， 硕士

【摘要】 随着改革开放和经济发展,居民生活水平有了很大的提高,医疗支出增长迅速。城乡二元化和城市化、政府医疗政策和医疗资源供给、老龄化是居民医疗支出的重要应影响因素。本文以Grossman的健康资本需求模型为理论基础,采用国家统计年鉴2003-2008年的省级面板数据,对居民医疗支出与相关影响因素的关系进行分析。采用了考虑收入及其他影响因素的实证分析方法。并且,在前人研究的基础上,本文根据现实情况对省级行政单位按照人均收入高低分为高中低三个区域,对城镇和农村分别进行回归以分析其差异,并加入了城市化、床位利用率、人均医生数等控制变量,得出更加准确的医疗支出的收入弹性。研究结果表明,城乡居民医疗支出的收入弹性确实存在差异,且最终结果农村高于城市；高收入地区城市的医疗支出弹性高于低收入地区；而农村医疗支出的收入弹性的地区差异并不明显。考虑城市化指标后,城镇居民医疗支出的收入弹性显著降低。并且城市化指标与城市居民的医疗支出均显著正相关。高收入地区人均医生数与城镇居民的医疗支出显著正相关,与农村居民医疗支出的关系不显著。而老龄化指标、床位利用率与城镇居民医疗支出的关系不显著,与农村居民的医疗支出显著正相关。最后,本文在进行相应的分析后提出如下建议：加大社会保障力度,对农村和低收入人群倾斜；医疗体系市场化的同时应加大对医疗服务机构的监管；切实保障城市化进程中外来人员的医疗利益；提高农村医疗的边际效率,切实减轻农民的医疗负担。更多还原

【Abstract】 With reform, opening-up and economic development, the living standards improved to a large extent and medical costs increase rapidly. The urban-rural dual economic structure, urbanization, transition of medical policies from government, and the aging people are influencing factors for medical expenditure.the paper is based on Grossman’s heath capital model of demand for health, employing panel data from 31 China provinces between 2003 and 2008 to analysis medical expenditure and its influencing factors with a model employing the empirical method of considering income and other factors. Based employs the empirical method of measuring income elasticity while considering other factors. Based upon reality, the thesis calculate the elasticity of medical expenditure more accurately, dividing provinces into three groups as high, middle and low income group, adding controlling variables such as urbanization and bed utilization rate.Results show that there is difference of income elasticity of medical expenditure between cities and rural areas. The elasticity in rural areas is greater than that in cities the elasticity of cities in high income group is greater than low income group; the income elasticity of rural areas shows no significant difference between groups. After considering urbanization, the income elasticity has dropped dramatically and shows a positive relation. The number of doctors correlates the medical expenditure in cities positively, but shows no significant relation in rural areas. Aging index shows no significant relation in cities, but correlates positively in rural areas.Finally, this thesis suggests:improve social security system, put more emphasis on low income group; strengthen supervision upon medical facilities; protect medical benefit of workers from rural areas in the process of urbanization;improve marginal efficiency of rural medical care, alleviate the medical care burden of rural residents.更多还原