發(fā)布時間：2018-05-06 08:47

  本文選題：醫(yī)療保險 + 計數(shù)回歸　； 參考：《華東師范大學》2014年碩士論文

【摘要】：醫(yī)療保障作為每個居民生產(chǎn)和發(fā)展的基本需求,一直受到各個國家的重視。我國也不斷進行著醫(yī)療保險改革,并且逐步建立了“城職工”、“新農(nóng)合”和“城居民”三大基本醫(yī)療保險為支撐的“全民醫(yī)�！斌w系。由于我國老齡化速度不斷增快,為了能進一步完善老年人群的醫(yī)療保障方案,開展醫(yī)保制度對老年人群保障效果的評價必不可少。國內(nèi)大部分學者從住院率、住院費用等方面對醫(yī)療保險的效果進行了分析,而本文另辟蹊徑,考慮到老年人慢性病高發(fā)的特點,從門診醫(yī)療服務利用的角度來對不同類別的醫(yī)療保險的效果進行評價。 本文共分為5章。第1章介紹了選題背景、文獻綜述、研究思路、方法和創(chuàng)新點等。第2章介紹了在實證分析時使用的統(tǒng)計模型,包括傾向得分匹配模型和多種計數(shù)回歸模型。第3章介紹了實證數(shù)據(jù)的來源和樣本基本信息,并結(jié)合描述性統(tǒng)計方法對樣本的醫(yī)療保險情況和門診費用進行了詳細分析。第4章利用統(tǒng)計模型實證分析了不同醫(yī)療保險對門診率和門診次數(shù)這兩個指標的影響,并且在分析門診次數(shù)時進一步區(qū)分了低、中、高年齡層次的老年人。第5章總結(jié)概括了全文,并提出了改進意見。 本文的主要結(jié)論包括：(1)三大基本醫(yī)保對于老年人群總體門診率和門診次數(shù)的提高均有顯著影響,但不同醫(yī)保的影響效果存在差異。(2)通過建立有限混合模型發(fā)現(xiàn),樣本老年人群中存在隱藏的兩類人群,一類為低門診利用率(普通)人群,另一類為高門診利用率人群。(3)“城職工”和“城居民”僅對低齡老年人門診次數(shù)的提升效果有統(tǒng)計顯著性,而“新農(nóng)合”對低、中、高三個年齡層次的提升效果均顯著,并且提升率隨著年齡層次增大而增大。(4)補充醫(yī)保對于門診率和門診次數(shù)的影響均不顯著。(5)不同老年人門診費用差異較大,總體門診自付比例較高。由此可以看出,基本醫(yī)保確實提高了老年人群對門診服務利用程度,但是也存在諸多方面需要進一步完善。
[Abstract]:As the basic demand of production and development of every resident, medical security has always been attached importance to by every country. Our country also carries on the medical insurance reform unceasingly, and has gradually established "the city worker", "the new rural cooperative" and "the city resident" three big basic medical insurance as the support "universal medical insurance" system. Because the aging speed of our country is increasing rapidly, in order to improve the medical security scheme of the elderly population, it is necessary to carry out the evaluation of the medical insurance system to the elderly population security effect. Most of the domestic scholars have analyzed the effect of medical insurance from the aspects of hospitalization rate, hospitalization cost and so on. However, this paper takes another approach, considering the characteristics of the high incidence of chronic diseases in the elderly. The effects of different types of medical insurance are evaluated from the perspective of outpatient medical service utilization. This paper is divided into five chapters. Chapter 1 introduces the background, literature review, research ideas, methods and innovations. Chapter 2 introduces the statistical models used in empirical analysis, including tendency score matching model and multiple counting regression models. Chapter 3 introduces the source of the empirical data and the basic information of the sample, and analyzes the medical insurance and outpatient expenses of the sample in detail with the descriptive statistical method. Chapter 4 empirically analyzes the influence of different medical insurance on outpatient service rate and outpatient frequency by using statistical model, and further distinguishes the elderly of low, middle and high age levels in the analysis of outpatient frequency. Chapter 5 summarizes the full text and puts forward some suggestions for improvement. The main conclusions of this paper are as follows: (1) the three basic medical insurance systems have significant effects on the overall outpatient rate and the number of outpatient visits of the elderly population, but there are differences in the effects of different medical insurance systems. There are two types of hidden population in the elderly population, one is the low outpatient utilization rate (ordinary) population, The other is the high utilization rate of outpatient service. 3) "urban workers" and "urban residents" have statistically significant effects on the increase of the number of outpatient clinics of the young elderly, while "New Rural Cooperation" has a significant effect on the promotion of the three age groups of low, middle and high age groups. And the promotion rate increased with the increase of age. 4) the effect of supplementary medical insurance on the outpatient service rate and the frequency of outpatient service was not significant. 5) the outpatient expenses of different elderly people were different greatly, and the overall outpatient outpatient payment ratio was higher. It can be seen that the basic medical insurance has improved the utilization of outpatient services, but there are many aspects to be further improved.
【學位授予單位】：華東師范大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R197.1;F842.684

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