制度类型、就医选择与政府补助对多维脆弱人群的医保减贫效应研究OA

Objective To explore the impact of different types of health insurance,medical institutions,and government subsidies on poverty alleviation among individuals suffering from serious illnesses.Methods This study was conducted on the basis of the 2018 China Family Panel Studies(CFPS)database,utilizing methods such as the calculation of catastrophic health expenditures and treatment effect models.Results Although the New Rural Cooperative Medical Scheme(NRCMS)had increased the willingness of the insured population to seek medical care,the incidence of catastrophic health expenditures among the insured remained as high as 13.6％,in-dicating a significant level of serious illness risk.In terms of medical institutions,compared to specialized and general hospitals,clinics had a catastrophic health expenditure incidence of 9.4％,demonstrating a close relation-ship between the location of healthcare service and the economic burden of diseases.While government subsidies had played a cooperative role to some extent,their effectiveness in providing support for multidimensional vulnera-ble populations was limited.For example,among individuals aged 65 and older,the incidence rate of catastrophic health expenditures for families not receiving subsidies was as high as 24.2％.Conclusions Different medical insurance systems need to be optimized and strengthened in terms of targeted protection.The root cause lies in the limited scale of the fund pool,which constrains the improvement of protection effectiveness.This suggests that tar-geted improvement recommendations are needed to ensure the fairness of institutional well-being for multidimen-sional populations.