Study On The Influence Of Basic Medical Insurance System On The Medical Service Utilization Of Floating Population

With the rapid development of urbanization,more and more floating population has joined the urban construction team.Affected by the living environment and the nature of employment,the health problems of the huge floating population have become increasingly prominent,and the demand for medical services has become more and more intense.Whether the floating population can seek medical treatment in time in case of illness and maintain their health level has become a social focus.Basic medical insurance is an important part of China’s social security system.The basic medical insurance aims at reducing the burden of individual diseases and improving the fairness of medical service utilization.However,from the perspective of relevant studies,scholars have not reached a consensus on whether the basic medical insurance system plays a positive role in promoting the utilization of medical services by patients.Some studies have proved that basic medical insurance can indeed improve the utilization level of medical services,while others believe that it has limited or no effect,or even plays a reverse inhibitory role.In addition,most relevant studies focus on the whole population and the elderly,and pay less attention to the floating population.Taking the floating population as the research subject,this study empirically analyzes whether basic medical insurance can play a positive role in improving the utilization level of medical services and reducing medical costs for the insured,so as to reduce the occurrence of "poverty due to illness,poverty due to illness" and other phenomena,which can provide certain facts and theoretical basis for related research fields and policy makers.In order to obtain the support of micro data,this thesis uses the 2018 data of China Migrants Dynamic Survey(CMDS),and takes the hospitalization rate,total hospitalization medical cost and out-of-pocket hospitalization medical cost of the floating population as the explained variables.The two part model is established to analyze the impact of basic medical insurance on the medical service utilization of the floating population.Specifically,The two part model is constructed to conduct regression analysis on the total inpatient medical expenses of the floating population.The first part of the two part model is the influence of basic medical insurance on the inpatient behavior choice of the floating population,and the robustness of the results is tested using the propensity score matching method.The second part analyses the results of basic medical insurance on the total cost of inpatient medical treatment of floating population,and tests the robustness of the sample selection model.Secondly,the two part model is constructed to analyze the out-of-pocket medical expenses of the floating population,and then grouping regression is carried out from the aspects of monthly household income and household registration type to determine whether there is heterogeneity in the explanatory variables to ensure the richness and reliability of the findings.Finally,the influence mechanism of basic medical insurance on medical service utilization is clarified to ensure the richness and reliability of the conclusions.The results show that:(1)Basic medical insurance can significantly improve the hospitalization rate of the floating population and improve the willingness of the floating population to seek medical treatment,which is also confirmed by the robust results of propensity score matching.Subdivide the places of hospitalization of the floating population into the places of residence and the places of residence or other places of hospitalization;The basic medical insurance system subdivides the types and places of the insured.Further inspection shows that there are differences in the types and places of the insured for the hospitalization rate of the floating population and their places of residence.(2)For the whole sample,participation in basic medical insurance can significantly reduce20.8% of the out-of-pocket hospitalization medical expenses of the floating population,and the results of the robustness test are passed,but it has no significant impact on the total hospitalization medical expenses of the floating population.In addition,in the heterogeneity analysis,basic medical insurance reduced the inpatient out-of-pocket medical expenses of the floating population in the high-income group and the non-agricultural group to a greater extent,which indicates that the impact of basic medical insurance on the inpatient out-of-pocket medical expenses of different floating population groups is very different.(3)The self-rated health status in the demand variable significantly affects the hospitalization behavior and hospitalization cost of the floating population.The better the physical fitness and the better the self-rated health status of the floating population,the lower the hospitalization probability,the less the total hospitalization cost and the less the hospitalization out-of-pocket medical expenses.Based on the empirical results,this thesis puts forward the following suggestions: the basic medical insurance system is an important tool to improve the health level of the floating population.It should be started from four aspects: improving the willingness of the floating population to participate in the basic medical insurance in the place of residence,accelerating the pooling level of the medical security system,increasing the preferential policies for the vulnerable groups,and improving the health awareness of the floating population.