Research On The Equality Of Medical Service Utilization Under The Background Of Urban And Rural Residents’ Medical Insurance System Integration

A sound medical insurance system is an important symbol of social development and progress,directly related to the well-being of the people.After nearly 70 years of reform and development,China’s medical security system has played an irreplaceable role in safeguarding people’s health and maintaining social stability.However,while seeing the great achievements of the medical insurance system,we should also pay attention to the inequality of medical insurance treatment between urban and rural areas,and the gap between the utilization of medical services between rural residents and urban residents has not been improved.In order to make urban and rural residents enjoy equal medical security,the integration of urban and rural medical insurance system has become an inevitable trend.In January 2016,the state council issued the opinions on the integration of the basic medical insurance system for urban and rural residents,which pointed out the need to gradually establish and improve the basic medical insurance system for urban and rural residents.By May 2019,China had completed the integration of the medical insurance systems for urban and rural residents in 24 provinces,with the remaining provinces accelerating the pace of integration.On this premise,this paper tries to find out the answers to the following questions: first,which factors mainly affect the utilization of medical services of urban and rural residents? Second,how much inequality exists between urban and rural residents in the utilization of medical services,and what factors lead to the inequality between urban and rural areas;Third,the effect of the integration policy of urban and rural medical insurance system on promoting equal opportunities.Equality theory,this paper,using the China health and pension track(CHARLS)2013 and 2015,two data,the April-Blinder decomposition,using the method of two footwork and Neumark Heckman to factors influencing health services utilization of urban and rural residents and differences were analyzed,and further decomposed,and the differences and inequality of opportunity factors in urban and rural residents medical service using the contribution of differences.Then,the dual difference method is used to test the implementation effect of the system integration,and then some targeted policy Suggestions are put forward for the integration of urban and rural medical insurance systems.The main conclusions are as follows:(1)The main influencing factors of medical service utilization of urban and rural residents are enabling variables,namely income,medical security policy and their own medical needs;(2)There is a huge inequality in the utilization of medical services between urban and rural residents,which is mainly due to the difference in income gap and medical insurance system.The dual medical insurance system in urban and rural areas results in 38.3% difference in outpatient medical treatment utilization and 30.2% difference in inpatient medical treatment utilization of urban and rural residents.(3)The integration of urban and rural medical insurance policies is conducive to reducing the opportunity inequality caused by the differentiated medical insurance system between urban and rural areas,which alleviates the opportunity inequality of 48.35% in outpatient medical service and 18.27% in inpatient medical service among urban and rural residents,respectively,with certain policy effects.Finally,Suggestions are put forward on the basis of the research: First,increase the investment in rural public health facilities,increase the financial input in rural public health facilities to improve the use of medical services for rural residents,and increase the medical resources available for rural residents.Increase education to enhance the ability to use medical resources to transform health resources into health capital.Second,we need to provide targeted assistance to low-income groups and vulnerable groups,further reduce their premiums,improve their use of medical services,and ensure the substantive equality of the medical insurance system.Third,Shared development will raise the income level of rural residents,so as to improve their health and achieve a virtuous circle.Fourth,we need to establish a dynamic mechanism for government investment,a stable and sustainable financing mechanism,establish and improve serious illness insurance for urban and rural residents,and raise the level of insurance coverage in urban and rural areas.