Health Performance And Mechanism Of New Rural Cooperative Medical System

To alleviate farmers "poverty due to illness", the Chinese government has introduced the new rural cooperative medical care system(Referred to NCMS). The health performance of NCMS refers to the degree of improvement of health level of the NCMS participants, and the mechanism refers to the way NCMS effects. Most of the current studies mainly focus on the implementation effect of NCMS, but the evaluation is also mixed. In addition, because of many factors influencing the full play of mechanism, caused the research on mechanism are vague and lacked of putting the mechanism into the health model. So it’s more practical significance to study the health performance and mechanism of NCMS.Because of the poor health of rural elderly and more sensitive to the price of medical services, so this paper study rural elderly as the object. Based on the review of research, this paper put forward there questions, including "How the health status of rural elderly in China?" "Whether had NCMS improved the health level of rural elderly?" "What was the mechanism of NCMS?". Based on CLHLS tracking survey data in 2005,2008,2011years, this article first analyzed the health situation of rural elderly from the perspective of spatial pattern and so on to solve the first question. Secondly, this paper divided samples into "participative group" and "control group" according to the situation of the rural elderly participation, made matching samples’ other conditions similar in addition to participation after PSM, analyzed the two matched groups using unconditional differences-in-difference and find out the differences between the two groups’health level in three period of time, analyzed the dynamic health performance of NCMS. Considering the difference of two groups’ health level may be caused by other confounding factors and based on multi-stage DID-Logit model, this paper analyzed health performance of NCMS from overall and different income level, coefficients and marginal effects to solve the second question. Then, in order to investigate whether the actual medical expenses and medical service utilization rate was the mechanism, this paper established the NCMS on the actual medical expense model and NCMS on the medical service utilization rate model to analyze the dynamic influence of the two. Then, based on multi-stage DID-Logit model, adding variables to measure the actual medical expenses and medical service utilization rate, this article solved the third question by analyzing the changing of net effect of NCMS; Finally, put forward policy suggestions according to the empirical results.Based on three period CLHLS data, this paper limited for the elderly aged 65 and above in rural areas, improved the traditional division of "participation", "control group" and established multi-stage DID-Logit model, finally draw the following conclusion by analyzing the dynamic health performance of NCMS:first, NCMS was conducive to the development of objective health, but reduced the subjective health assessment; Secondly, in the initial, NCMS exacerbated the equality of health, although this phenomenon was alleviated in the medium term; Thirdly, NCMS improved the health of elderly by increasing the utilization rate of approach, but the overall effect decreased year by year.