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我国社会基本医疗保险体系存在着“碎片化”特征。不同医保制度在筹资方式、待遇水平以及管理方式上都存在着差别,导致了我国城乡居民医疗服务利用水平的差距较大。因而,社会基本医疗保险的整合在促进医疗服务利用、消除城乡差异、提高社会公平性等方面均有着重要的意义。本文使用2014年和2015年南沙区城乡居民医疗保险的就诊数据,通过采用双重差分法对医保整合的政策效应进行了回归分析。实证结果表明,实施城乡居民医保整合后,农村居民在医疗服务支出及就诊次数上均得到了有效的提升,但与城镇居民还存在较大差距。另外,城乡居民医疗服务的自付比例仍然较高,对于城乡居民来说有较大压力。最后,基于上述实证研究,本文对完善广州市社会医疗保险政策提出了几点建议。
The basic medical insurance system in our country is characterized by “fragmentation”. Different medical insurance systems have differences in terms of fund-raising methods, treatment levels and management methods, resulting in a large gap between the utilization of medical services by urban and rural residents in China. Therefore, the integration of social basic medical insurance is of great significance in promoting the utilization of medical services, eliminating the differences between urban and rural areas, and improving social fairness. This paper uses the data of medical insurance for urban and rural residents in Nansha District in 2014 and 2015 and conducts a regression analysis of the policy effect of health insurance integration by using the double difference method. The empirical results show that after the integration of urban-rural medical insurance is implemented, the rural residents have been effectively promoted in the expenditure on medical services and the number of visits, but there is still a long way to go to urban residents. In addition, the proportion of urban-rural residents who pay for their medical services is still high, which puts a lot of pressure on urban and rural residents. Finally, based on the above empirical research, this article puts forward some suggestions on perfecting the social medical insurance policy in Guangzhou.