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本文通过对成都市4县(区)1775位居民的抽样调查,运用泰尔指数、基尼系数和洛伦兹曲线,从医疗服务利用的视角对成都市城乡居民基本医疗保险的公平性进行评价。研究发现:城乡统一的基本医疗保险一定程度上促进了居民的医疗服务利用,且住院服务利用的公平度显著好于门诊服务利用;是否参保及参保档次放大了医疗服务利用的不公平性。加强对特殊群体的健康关注度和对医疗机构的监管力度是进一步完善基本医疗保险制度的重点。
Based on the sample survey of 1775 residents in 4 counties (districts) in Chengdu, this paper evaluates the equity of urban and rural residents’ basic medical insurance in Chengdu from the perspective of medical service utilization by using Theil index, Gini coefficient and Lorenz curve. The study found that the unified basic medical insurance in urban and rural areas promoted the utilization of medical services to some extent, and the fairness of inpatient service utilization was significantly better than that of outpatient service utilization. Whether the insured and insured grade magnified the inequity of medical service utilization . Strengthening the health awareness of special groups and the supervision of medical institutions are the key points to further improve the basic medical insurance system.