户籍类型与城乡居民医疗服务利用 ——基于Andersen模型的经验分析

本文利用中国社会科学院经济研究所2018年城乡居民入户调查数据,从户籍改革角度分析户口类型改变对城乡居民医疗服务利用的影响。研究发现:与户口类型未发生改变的城乡居民相比,户口类型发生过改变(农转非)的城乡居民门急诊服务利用的可能性更高,住院医疗服务支出水平更低。从户籍改革与参保类型交互效应看,相对于户口类型未发生过改变的居民医保参保人群,户口类型发生改变(农转非)会显著提高居民医保参保人群门急诊服务利用,同时降低其住院服务利用。进一步采用PSM方法进行稳健性检验,户籍改革对提高城乡居民门急诊服务利用,降低住院医疗服务利用的结论依然成立。此外,本文还发现,直接结算提高了城乡居民门急诊和住院的就诊概率;健康自评状况越差,门急诊和住院医疗服务利用可能性越高,门急诊医疗支出、住院医疗支出和跨省异地就医支出也越高。本文认为,相对于推行基层分级诊疗制度,以户籍改革推动农村居民自由流入医疗资源更丰富的城镇地区,改革基层卫生院制度,以及改变基层医疗服务提供激励机制,可能更有助于改善农村居民健康状况。     

空气污染、社会经济地位与居民健康不平等——基于CGSS的微观证据

本文利用中国综合社会调查(CGSS)数据,基于Grossman健康生产函数详细考察空气污染、社会经济地位对居民健康的影响机制及城乡异质性,进一步识别空气污染与社会经济地位协同作用对居民健康不平等的分化机制。研究结果显示在中国18岁及以上的成年人口中,社会经济地位较高的人群拥有更好的自评健康水平,这种群体健康分化主要来自社会经济地位正效应和空气污染负效应的综合影响。城乡居民之间的健康差异主要来自收入的绝对差异和偏效应差异以及社会阶层和教育水平的城乡差异。空气污染对居民健康不平等具有显著的分化机制,其作用途径是通过调整社会经济地位尤其是收入效应来实现的,这种分化机制在城市居民中表现得尤为突出。因此,相关政策的设计实施应该更加关注环境健康风险以及健康不平等的加剧:一是要加强环境规制,严控大气污染,降低居民整体暴露风险;二是要推进基本公共服务均等化,提高弱势群体应对健康风险的能力;三是要加强城乡教育培训的扶持力度,缓解收入差距和教育分化引致的健康不平等。     

老年人社会照料和医疗服务使用的不均等性分析

文章利用集中指数(CI)及其分解方法衡量了中国老年人在社会照料和医疗服务使用中的不均等性,以及各因素对不均等的贡献率。结果表明,相对于医疗服务,老年社会照料使用中存在明显的由非需要类变量引起的亲富人不均等,各因素对二者不均等性的影响方向基本一致,其中收入和城乡分布是不均等的主要根源,社区服务和保险等因素也都表现出了不同的影响和变化趋势。作者建议按照老年人的实际需要分配照料服务资源,并将老年服务纳入城乡和地区均衡发展战略。     

生命周期视角下与收入相关的健康不平等分析——基于组群分析的方法

本文利用中国健康与营养调查数据,从生命周期的视角对与收入相关的健康不平等的年龄特征和变动进行了基于组群分析的实证研究。研究结果表明：与收入相关的健康不平等随着年龄的增长不断扩大：不同年龄段的健康不平等均呈现不断扩大的变动趋势,45岁以上人群的变动幅度要相对大于45岁以下人群;教育、收入和医疗的不平等是与收入相关的健康不平等扩大的主要原因,但是对45岁以下人群健康不平等的影响要大于45岁以上人群;此外,本文还进一步分析了年龄老化对健康不平等变化的影响路径。     

农村内部收入不平等变动的成因——基于回归分解的研究途径

近年来中国农村居民收入持续增长,但是农村收入差距却持续扩大。采用回归分解的方法,利用吉林省农户抽样调查数据,对农村内部收入不平等及其变动趋势的成因进行分析。研究结果表明,劳动力投入、工资性收入和人力资本对农户收入的增加起到明显的作用;影响农村收入不平等水平的要素有劳动力投入、耕地、工资性收入、人力资本要素以及地区差异;耕地、工资性收入和劳动力投入对农村内部收入不平等的增加有显著影响,其中耕地的作用占51.60%,超过一半的解释能力,而教育对降低收入不平等水平有一定的作用。     

老年人利用医疗服务的影响因素分析

本文运用logisitic回归模型,从医疗服务利用与否和医疗服务利用程度二个层面分析了老年人利用医疗服务的影响因素,即存在哪些因素促进或阻碍着老年人对医疗服务的利用。结果表明,身体健康状况、医疗制度和经济状况是影响老年人利用医疗服务的基本因素。为适应我国人口老龄化的趋势,保证老年人能享受基本的医疗服务,改革和完善我国现行医疗保障体制,建立有中国特色的城、乡医疗保险制度势在必行。     

中老年家庭灾难性医疗支出的测度及影响因素 ——基于CHARLS数据的实证

基于2011-2015年三期平衡面板数据,对中老年家庭的灾难性医疗支出进行测度并分析其影响因素。研究发现:我国中老年家庭灾难性医疗支出发生率在考察期内进一步扩大,差距也进一步上升。以家庭可支付能力的40%为灾难性医疗支出的界定标准,则在2015年其发生率依然高达25.4%,平均差距为0.069,相对差距为0.272。引入安德森医疗服务利用模型对影响因素进行分析,结果显示家中有住院、门诊及残障人员更容易发生灾难性医疗支出,经济状况对灾难性性医疗支出发生起着显著作用,总体而言灾难性医疗支出具有"亲贫"效应,越是贫困的家庭越容易发生灾难性医疗支出。据此,文章提出应该采取分类管理的措施,通过发放免费医疗服务券、强化医疗费用控制等政策建议来切实降低灾难性医疗支出的发生。     

卫生医疗资源的可及性与农村儿童的健康问题

文章利用中国健康与营养调查2000年数据,分析目前中国农村卫生医疗资源的可及性及其对农村儿童健康状况的影响。实证结果发现,卫生医疗资源对不同社会经济特征家庭具有不公平的可及性。新时期卫生医疗资源的投入和使用应更着眼于提高农村儿童及其家庭公平享有卫生医疗资源的程度,从而有效地提高贫困及低受教育水平家庭儿童的健康水平,促进农村地区和谐发展。     

社会医疗保险对老年人卫生服务利用的影响——基于倾向得分匹配的反事实估计

人口老龄化使老年人社会医疗保险和医疗消费成为重要的社会问题,但目前中国仍然缺乏对医疗保险影响老年人卫生服务利用的准确估计。文章基于2011年"中国城乡居家养老服务"调查数据,使用倾向得分匹配方法,估计社会医疗保险对老年人卫生服务利用的影响。结果发现社会医疗保险会显著增加老年人的医疗卫生服务利用,其中,老年人获得医疗保险会平均增加医疗消费约900元/年,城市老年人获得医疗保险后医疗消费约增加1 200元/年,男性老年人获得医疗保险后增加医疗支出约1 000元/年。在估计结果的基础上,文章分析了医疗保险需要与获得的非匹配性等问题,并提出强化基本医保制度底层福利设计等建议。     

老年人健康不平等的发展趋势研究

在我国进入“普雷斯顿曲线”转折点即将步入富裕国家行列,以及人口结构高龄化、疾病谱系慢病化、社会保障完善化等宏观健康场域发生转换的背景下,基于布迪厄社会实践理论,使用中日两地共同跟踪调查数据与结构方程模型,揭示了国家富裕化前后老年人健康不平等机制及其发展趋势。得出如下结论：第一,老年人的资本、惯习、健康具有以资本为基础的三角形生成性路径关系,老年人健康不平等包括资本通过资源直接路径作用于健康导致的系统健康差异和资本通过控制惯习的间接路径作用于健康导致的系统健康差异;第二,在国家富裕化前的宏观健康场域下,老年人健康不平等主要来自资本的直接路径;第三,国家富裕化引发宏观健康场域的转换,促使资本导致老年人健康不平等的总量有所消减,资本基于资源属性直接路径导致的健康不平等大幅度消减,而资本通过惯习控制行为属性间接路径导致的健康不平等大幅度上升。因此,在国家富裕化带来宏观健康场域转换过程中,资本对健康的外源性作用逐步下降,而对健康的内控性作用逐步上升,导致老年人健康不平等产生机制发生根本性改变,为我国消减老年人健康不平等政策提出新课题。     

Differentials in divorce in maryland

The basic data needed for measurement of the risks of termination of the legal relationship of marriage by characteristics of the marital partners are not available at this time for the United States because the national divorce registration area includes less than half the States. Special studies based on selected census data or the records of marriages and divorces occurring in one State or community have provided much of the valuable but limited information at hand. Statistics for individual States are subject to substantial bias as a consequence of inter-State migration between time of marriage and time of divorce, but they must serve as a basic data source until national reporting has improved. A record linkage study was undertaken which tied marriages occurring in the State of Maryland in 1959 with divorces occurring in the State in the years 1959–66. Relative, not actual, divorce risks by race, age at marriage, and previous marital status were calculated for couples with at least one partner an in-State resident at the time of marriage. The dissolution rate was higher for whites than for nonwhites. Marriages contracted by persons at very youthful ages and by persons who had been married previously were found subject to greater than average risks of dissolution through divorce.     

城市计划生育技术服务方式创新--南京市玄武区政府购买计划生育技术服务的实践

建立政府牵头、计卫联手、资源共享的计划生育技术服务体系 ,开展以知识普及、知情选择、随访服务、咨询指导、健康促进为主要内容的计划生育避孕节育和生殖保健优质服务 ,最大限度地满足社区育龄群众在计划生育和生殖保健方面的需求 ,是城市计划生育技术服务改革发展的方向1 。近几年 ,南京市玄武区计划生育局在区委、区政府的领导以及省市计生委的支持下 ,根据新时期城市计划生育工作改革发展要求 ,积极推进政府计划生育部门的职能转变 ,探索计划生育技术服务方式的改革创新 ,尝试依托社区医疗卫生和妇幼保健服务网络 ,由政府购买计划生育…     

Major Tasks in Health and Family Planning in China in 2015

On January 12,2015,at the regular press briefing of National Health and Family Planning Commission(NHFPC),NHFPC reported the major tasks in health and family planning in China in 2015.The details are as follows:In-depth Development of Medical and Health System Reform In-depth Development of Medical and Health System Reform.     

Increases in childlessness in New Zealand

New Zealand’s fertility fell below the theoretical replacement level (2.1 births per woman) for the first time in recorded history in 1978. It has hovered at or below replacement level ever since. The result, an impression of relative stability, belies changes taking place. Data from the 1981, 1996 and 2006 censuses show a pattern of delayed childbearing and increased childlessness. In a little over 30 years, childlessness has shifted from being almost entirely a consequence of a couple’s infecundity to being as frequently a result of a woman’s life choices. The steady rises in childlessness recorded by successive cohorts suggest that childlessness is already having a significant effect on New Zealand fertility. Patterns in characteristics of those women choosing not to start families, as well as subtle differences in these patterns between New Zealand and other developed nations, suggest that there is a significant potential for childlessness to cause a more dramatic shift in New Zealand’s total fertility rate. This analysis examines growth in childlessness in relation to marital status, country of birth, ethnicity, regional and urban differentials, religion, and educational attainment of women who were childless at the 1981, 1996 and 2006 censuses.

Shifts in Reproductive Patterns in China

The People's Republic of China, during the second half of the twentieth century, has been repeatedly affected by social and political upheavals associated with government policies. These have produced strong but unexpected impacts on Chinese demographic patterns. Many of these policies are of the sorts that alter reproductive costs and benefits. This study examines patterns in Hebei, Shaanxi, and Shanghai, three provinces with differing ecological, geographic, and economic characteristics. Government policies affected the three populations differentially; this was evident at both aggregate and individual levels. The Great Leap Forward and subsequent famine created higher birth deficits and mortality among the largely rural populations of Hebei and Shaanxi than the more urban Shanghai. In contrast, the Cultural Revolution and family planning resulted in lower fertility levels for women in Shanghai. The population history of China during the second half of last century thus reflects strong state interventions in the lives of its citizens. Government policies, along with regional variations in geographic, social, and economic conditions, strongly influence individual access to resources in China. Variations in timing and intensity of women's reproductive patterns reflect differential access to resources and subsequent trade-offs.     

Materialism in Pedagogy Students in Chile

Many studies have used Richins and Dawson’s (J Consum Res 19: 303–316, 1992) Material Values Scale (MVS), applying it to different types of populations that exhibit a particular psychometric behavior, and showing little stability in their factorial structure. In the present study, 1,070 pedagogy students from the northern, central and southern regions of Chile answered the MVS. This sample was randomly divided in two. Using the first sub-sample (N = 539), an exploratory factorial analysis was carried out, from which a structure of nine items was grouped into two factors called “Social Success” and “Personal Happiness”, which presented adequate reliability. Later, with the second sub-sample (N = 531), the factorial structure indicated above was put to the test through a confirmatory factorial analysis. The data from the model show that the scale contains 8 items in total, grouped into two dimensions. The factorial loads are significant at the level of 1 %, which indicates that the 2-factor structure can be confirmed. Finally—using the proposed structure—the presence of the students’ material values was evaluated.     

论西部开发中的城市发展问题

本文在对近20年来我国城市发展进行回顾与反思的基础上,提出了西部制定城市发展战略和选择城市发展道路的基本原则以及若干城市发展对策措施.     

Trends in life expectancy in wellbeing

Objectives: This paper describes anddiscusses trends in life expectancy inwellbeing between 1989 and 1998.Methods: Data on wellbeing by theBradburn Affect Balance Scale is obtained fromthe Netherlands Continuous Health InterviewSurveys for the calendar years from 1989 to1998. Using Sullivan's method, life expectancyin wellbeing is calculated.Results: For males at the age of 16, lifeexpectancy in wellbeing increases significantlyfrom 52.7 years in 1989 (90.1% of the totallife expectancy) to 54.4 years in 1998(90.8%). This increase is almost completelycaused by the increase in total lifeexpectancy. For females at the age of 16, lifeexpectancy in wellbeing raises significant from54.4 years in 1989 (84.1%) to 56.2 years in1998 (86.3%). This increase is almostcompletely caused by a decrease in the numberof years in a state of distress.For both males and females at the age of 65,the significant increase of life expectancy inwellbeing exceeds the increase in total lifeexpectancy and is mainly caused by the decreasein number of years in distress.Conclusion: Contrary to life expectancyin good perceived health and to disability freelife expectancy – which show a decreasing trend– the overall wellbeing of the population isincreasing. It seems that aspects in human lifethat contribute to wellbeing or quality of lifeother than physical health are gaining inimportance. This makes life expectancy inwellbeing a less appropriate instrument tomonitor changes in population health, but auseful instrument to measure population qualityof life.     

Changes in Living Standards and Depopulation in Latvia in the 1990s

Social Indicators Research -     

"非典"期间全国农村地区跨省流入人口调查数据分析

在2003年抗击非典的关键时期,国家人口和计划生育委员会进行了全国农村地区跨省流入人口的调查.本文着重分析这项调查所获得的数据,并对数据的一致性做出说明.既揭示了我国农村流动人口的基本特征和非典时期农村人口流动的规模和流向特点,又反映了非典对这一时期全国人口的流动所产生的影响,同时展示了我国抗击非典工作在农村地区所取得的成绩.