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随着我国经济发展阶段的逐步深入,公平问题越来越受到社会的重视,医疗卫生领域的公平问题已经成为当今社会的焦点之一。虽然已经有些学者对我国居民的医疗消费不公平问题进行过研究,但尚没有正式和严谨的检验:究竟是否存在医疗消费不公平性问题?存在哪种形式的不公平?本文提出了一种医疗消费(不)公平性的判断方法,并利用中国健康与营养调查2006年的微观数据,借助CLAD方法对医疗消费的归并模型进行了估计。结果显示:我国居民的医疗消费主要由个人的医疗需要决定,同时也受收入水平的影响,但与是城市还是农村居民的关系不够显著。这说明现时期我国确实存在医疗消费不公平问题,其表现形式是不同收入阶层之间的不公平,不存在城乡居民之间的不公平。本文比较稳健的实证检验结果对我国医疗改革的战略调整和具体政策措施的制定都有重要的参考价值。
With the gradual deepening of China’s economic development stage, the issue of equity has received more and more attention from the society. The issue of fairness in the medical and health field has become one of the focuses of today’s society. Although some scholars have conducted research on the unfairness of Chinese residents’ medical consumption, there is no formal and rigorous test: Is there any question of unfairness in medical consumption? What kind of inequity exists? This paper proposes a kind of medical treatment. The consumption (non) judgment method of fairness, and using the micro-data of the 2006 China Health and Nutrition Survey, the CLAD method was used to estimate the merger model of medical consumption. The results show that the medical consumption of Chinese residents is mainly determined by the individual’s medical needs, but also by the level of income, but the relationship with the urban or rural residents is not significant enough. This shows that in the current period, there is indeed an issue of unfairness in medical consumption in China. Its manifestation is the inequality between different income strata. There is no unfairness between urban and rural residents. This article’s comparatively robust empirical test results have important reference values for the strategic adjustment of China’s health care reform and the formulation of specific policy measures.