摘要
自2009年开始,中国进入后新农合时代,新农合在增进农村医疗服务质量,提高农村居民健康素养方面效果突出,但面临的阻力不断增大。本文运用Heckman双阶段模型和一手调研数据研究农村居民对新农合参与的影响因素、满意度、支付意愿等重要问题。当前参合居民对新农合满意度较高,可接受的最大参合费用均值为185.55元·人/年。防大病、节省医药开支是农村居民继续参合的主要原因,参合费用太高则成为参合者中断参与新农合的首要因素,而医院诊疗费用增幅过大、参合费用上涨太快、大病报销比例偏低、政策宣传不够等则是参合者的主要担忧。个人特征变量对个体参与意愿与支付意愿选择的影响比较微弱,家庭特征变量(家庭年收入、是否有欠款、是否通村公路、医疗距离、是否开通有限电视)和参与特征变量(参合时长、新农合满意度、门诊报销是否超出补偿上限、是否报销过住院(手术)费)等是决定参合者参与意愿与支付意愿的关键变量。本文最后给出了相关政策建议。
Since 2009, the New Type of Rural Cooperative Medical Care System （NCMS） which was aimed to enhance the level of rural medical service, improve physical and mental health and reduce poverty caused by illness, has come to a new era. At the same time, NCMS faces more and more new challenges. Based on first hand data, using Heckman two-phase mode, the paper investigates factors affecting Chinese rural residents＇ participation, satisfaction and willingness to pay for NCMS. The study finds that rural residents are generally satisfied, and have a strong participating willing, the blocking effect of participation fee rising is modest. En- rollees＇ willingness to pay is 185.55 yuan person/year, and the current participation fee is within the acceptable level of participants. Saving of medical expenses and fear of serious illness are the main reasons for participation, and the high cost becomes the most important factor for not par- ticipating. Major concerns of participants include rising fee and medical expenses, low level of compensation and little explanation of policies. Individual features have little influences over participation and willingness to pay, while family factors like income, loan level, road condi- tion, distance to hospital, heavy illness and cable television, and participation features like satisfaction level, duration, whether compensated with operation cost, are significant factors impacting their participation and willingness to pay. Policy suggestions are given in the last part of the paper.
出处
《南开经济研究》
CSSCI
北大核心
2017年第3期3-17,共15页
Nankai Economic Studies
关键词
农村居民
新农合
参与
支付意愿
Rural Residents
New Type of Rural Cooperative Medical Care System （NCMS）
Participation
Willingness to Pay
