The effect of medical insurance impact on Chinese eiderly~s medical expenses：results from the survey of CLHLS
- 公共卫生－已发表论文 
目的分析中国60岁及以上老年人医疗费用的影响因素，探讨医疗保险类型及其作为主要支付者对老年人医疗费用的影响。方法基于2011-2012年CLHLS调查数据，应用Kruskal-Wallis检验和多元线性回归模型分析老年人医疗费用的影响因素，同时探讨医疗保险类型及其作为主要支付者对老年人医疗费用的影响。结果参加新型农村合作医疗和其他补充医疗保险可显著缓解老年人的医疗费用；从主要支付者分析，虽然参加了医疗保险，但多数老年人医疗费用仍以自付为主；新型农村合作医疗和商业医疗保险作为主要支付者可以缓解老年人医疗费用压力。结论应提高老年人基本医疗保险的参保率和新型农村合作医疗保险的报销比例，发挥基本医疗保险在缓解老年人医疗费用负担中的作用；同时促进老年人商业医疗保险参与，扩大社会医疗救助机构或养老中心的建设，缓解老年人医疗费用负担。Objective To analyze the influence factors of medical expenses of the elderly, explore the effect of different health in- surance on medical expenses and discuss how the medical insurance as the main payment to influence medical expenses. Methods Kruskal- Wallis test and general multivariate linear regression model were used to analyze the influence factors based on the data from CLHLS in 2011 - 2012. Results The participating in the new rural cooperative medical insurance scheme （NCMS） and urban residents basic medical insurance （UR-BMI） were significantly related to the level of the elderly＇s medical fees, medical expenses of the elderly were mainly paid by themselves, the NCMS and commercial medical insurance as the main payment eased the pressure of medical expenses for the elderly. Con- clusions The expanding coverage of basic medical insurance and reimbursement ratio of the NCMS, encouraging the elderly to participate in commercial medical insurance, expanding social assistance institutions or pension institutions could alleviate the pressure on medical expen- ses for the elderly.