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解决低保户看病难问题事关社会底线公平。文章基于2005年三个西北城市的17 690个样本对低保户就医问题展开实证研究,分析结果表明,由于中国医疗机构扭曲的激励机制和偏重住院报销的给付结构,低保户和非低保户两个群体都倾向于自己购药处理日常病患,而减少了门诊利用,经常面临生存危机的低保户由此拖延病情直至病情严重;个人账户既不能横向分散不同人群的疾病风险,也不能纵向分散个人在生命周期不同阶段的疾病风险;职工基本医疗保险能够显著增加中青年低保户对住院服务的利用,但对老龄低保户没有效果。
Solving the difficult problem of subsistence allowances for family members is about the bottom line in society. Based on 17 690 samples of three northwestern cities in 2005, the paper conducts an empirical study on the medical treatment of MLSS households. The analysis shows that due to the distorted incentive mechanism of Chinese medical institutions and the pay structure that emphasizes hospitalization reimbursement, the minimum living guarantee households and non- Both groups tended to purchase their own medicines to treat routine patients and reduced the use of outpatient clinics and those subsistence allowances frequently facing a crisis of survival delayed the condition till their serious condition. Individual accounts could not horizontally disperse the disease risk of different groups of people, Individuals’ risk of disease at different stages of the life cycle can not be dispersed vertically. Basic medical insurance for staff and workers can significantly increase the utilization of inpatient services for young and middle-aged subsistence-assured households, but has no effect on those who are aged.