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目的 :分析职工医保制度对缩小不同收入人群卫生服务利用差距的影响。方法 :利用黑龙江省卫生服务调查中职工医保的数据进行分析。结果 :2013年城镇职工最低收入组的住院率是最高收入组的1.91倍;最低和较低收入组的应住院而未住院率分别是最高收入组的1.41倍和1.78倍;住院自付比是较高收入组的1.36倍和1.48倍。结论 :城镇职工医保制度覆盖面与补偿力度的增加,改善了低收入人群的卫生服务利用,但仍未能从根本上消除其服务利用的经济障碍,应强化消除低收入人群公平性差距的医保制度设计。
OBJECTIVE: To analyze the impact of employee health insurance system on narrowing the gap in health service utilization among different income groups. Methods: The data of employee health insurance in Heilongjiang Health Service Survey were analyzed. Results: The lowest income group of urban workers in 2013 was 1.91 times of the highest income group; the lowest and lowest income groups were 1.41 times and 1.78 times of the highest income group, respectively; the out-of-hospital expenditure ratio was 1.36 times and 1.48 times higher than the higher income group. Conclusion: The coverage of medical insurance system for urban workers and the increase of compensation have improved the utilization of health services in low-income groups. However, the economic barriers to service utilization have not been eliminated fundamentally. The health insurance system that eliminates the gap in fairness among low-income groups should be strengthened design.