中国流动人口医疗保险参保空间格局及其影响因素——基于全国流动人口动态监测调查数据的分析
|
摘要
基于2015年全国流动人口动态监测调查数据,利用探索性空间数据分析(ESDA)技术分析中国335个地级单元流动人口医保参保率的空间依赖性和空间异质性,并采用地理加权回归(GWR)模型从流动人口的个体因素、流入地区的社会因素和流动因素3个方面分析对医保参保率的影响。结果表明:(1)流动人口医保参保率空间格局呈现西高东低的阶梯状格局,高参保率地区主要沿陇海铁路线分布,低参保率地区聚集于东北三省和新疆地市。(2)地级单元流动人口医保参保率存在显著的空间关联性,整体呈现空间集聚形态;参保率热点区以中原城市群为核心,冷点区主要分布在东北和西南地区。(3)工资水平、户口性质、单位性质、职业类型、从业结构、医疗资源和流入地区对流动人口医保参保率影响显著,但对不同地区医保参保率的影响度存在明显差异。
Based on national survey data of dynamic monitoring of the floating population in 2015,the exploratory spatial data analysis( ESDA) technical was used to analyze the spatial dependence and spatial heterogeneity in medical insurance participation rate of floating population among 335 prefecture-level units,the geographically weighted regression( GWR) model was used to analyze the influence of the individual factors of the floating population,the social factors of the inflow areas and the flow factors on the medical insurance participation rate. The research indicates that:( 1) The spatial pattern of the medical insurance participation rate of the floating population shows a stepped pattern of high west and low east,the high participation rate areas are mainly distributed along the Longhai Railway and the low areas are concentrated in the three provinces in Northeastern China and the cities of Xinjiang.( 2) There is a significant spatial correlation between the medical insurance participation rate of the floating population in the prefecture-level unit,and the overall formed of a spatial agglomeration. The hot spot area is centered on the central plain urban agglomeration and the cold spot areas are mainly distributed in the Northeast and Southwest regions.( 3) The wage level,the nature of the account,the nature of the unit,the type of occupation,the structure of employment,the medical resources and inflow area have a significant effect on the medical insurance participation of the floating population,however,there are obvious differences in the influence degree on the rate of medical insurance participation in different regions.
Based on national survey data of dynamic monitoring of the floating population in 2015,the exploratory spatial data analysis( ESDA) technical was used to analyze the spatial dependence and spatial heterogeneity in medical insurance participation rate of floating population among 335 prefecture-level units,the geographically weighted regression( GWR) model was used to analyze the influence of the individual factors of the floating population,the social factors of the inflow areas and the flow factors on the medical insurance participation rate. The research indicates that:( 1) The spatial pattern of the medical insurance participation rate of the floating population shows a stepped pattern of high west and low east,the high participation rate areas are mainly distributed along the Longhai Railway and the low areas are concentrated in the three provinces in Northeastern China and the cities of Xinjiang.( 2) There is a significant spatial correlation between the medical insurance participation rate of the floating population in the prefecture-level unit,and the overall formed of a spatial agglomeration. The hot spot area is centered on the central plain urban agglomeration and the cold spot areas are mainly distributed in the Northeast and Southwest regions.( 3) The wage level,the nature of the account,the nature of the unit,the type of occupation,the structure of employment,the medical resources and inflow area have a significant effect on the medical insurance participation of the floating population,however,there are obvious differences in the influence degree on the rate of medical insurance participation in different regions.
引文
[1]纪颖,袁雁飞,栗潮阳,等.流动人口与农村青年人口健康状况及卫生服务利用的比较分析[J].人口学刊,2013,35(2):90-96.
[2]董晔,安瓦尔·买买提明.城镇化进程中乌鲁木齐市少数民族农民工空间分布及生存状态研究[J].地理科学,2014,34(8):963-970.
[3]岳经纶,李晓燕.社会视角下的流动人口健康意识与健康服务利用——基于珠三角的研究[J].公共管理学报,2014,11(4):125-135.
[4] LEVECQUE K,LODEWYCKX I,VRANKEN J. Depression and Generalised Anxiety in the General Population in Belgium:A Comparison between Native and Immigrant Groups[J]. Journal of Affective Disorders,2007,97(1/2/3):229-239.
[5] LINDERT J,SCHOULER-OCAK M,HEINZ A,et al. Mental Health,Health Care Utilisation of Migrants in Europe[J].European Psychiatry,2008,23(1):14-20.
[6]罗小琴,桂江丰.流动人口参加城镇职工医疗保障的行为及成因分析[J].人口与发展,2014,20(6):43-50.
[7]朱宇.国外对非永久性迁移的研究及其对我国流动人口问题的启示[J].人口研究,2004,28(3):52-59.
[8]蔚志新.流动人口社会保险参与状况的地区差异分析——基于2011年全国32个省级单位的流动人口问卷调查[J].人口学刊,2013,35(2):81-89.
[9]秦立建,惠云,王震.流动人口的社会保险覆盖率及其影响因素分析[J].统计研究,2015,32(1):68-72.
[10]石人炳,陈宁.城-城流动人口养老保险参保影响因素研究——基于全国流动人口动态监测数据的分析[J].人口研究,2015,39(4):102-112.
[11]施佳华,李娜,尹清菊,等.上海市外来务工人员医保参保现状及影响因素分析[J].医学与社会,2017,30(3):51-54.
[12]刘冬梅,王晖,龚双燕,等.中国流动人口重复参加基本医疗保险现状及影响因素[J].中国公共卫生,2016,32(1):62-65.
[13]李红娟,杨菊花.流动人口城镇职工医疗保险水平的区域差异研究[J].人口与社会,2017,33(3):3-12.
[14] JENSEN H H,SAUPE W E. Determinants of Health Insurance Coverage for Farm Family Households:A Midwestern Study[J]. North Central Journal of Agricultural Economics,1987,9(1):145-155.
[15] BARRETT G F,CONLON R. Adverse Selection and the Decline in Private Health Insurance Coverage in Australia:1989—1995[J]. Economic Record,2003,79(246):279-296.
[16] CHENG Z,NIELSEN I,SMYTH R. Access to Social Insurance in Urban China:A Comparative Study of Ruralurban and Urban-urban Migrants in Beijing[J]. Habitat International,2014,41:243-252.
[17] KARL J B,BORN P H,VISCUSI W K. The Relationship between the Markets for Health Insurance and Medical Malpractice Insurance[J]. Applied Economics,2016,48(55):5348-5363.
[18] SHI J L. Efficiency in Plan Choice with Risk Adjustment and Risk-based Pricing in Health Insurance Exchanges[J]. Geneva Papers on Risk and Insurance:Issues and Practice,2017,42(1):79-113.
[19] CAMERON A C,TRIVEDI P K,MILNE F,et al. A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia[J]. The Review of Economic Studies,1988,55(1):85-106.
[20]唐丹.流动人口参加工伤保险影响因素的定量分析——以北京、绍兴、东莞为例[J].人口研究,2011,35(5):36-44.
[21]刘志军,王宏.流动人口医保参保率影响因素研究——基于全国流动人口动态监测数据的分析[J].浙江大学学报(人文社会科学版),2014,44(5):161-174.
[22]张香玲,李小建,朱纪广,等.河南省农业现代化发展水平空间分异研究[J].地域研究与开发,2017,36(3):142-147.
[23]张耀军,任正委.基于地理加权回归的山区人口分布影响因素实证研究——以贵州省毕节地区为例[J].人口研究,2012,36(4):53-63.
[24] ANSELIN L. Spatial Externalities,Spatial Multipliers and Spatial Econometrics[J]. International Regional Science Review,2003,26(2):153-166.
[25] GETIS A,ORD J K. The Analysis of Spatial Association by Use of Distance Statistics[J]. Geographical Analysis,1992,24(3):189-206.
[26]李在军,管卫华,蒲英霞,等.山东省旅游经济的时空演变格局探究[J].经济地理,2013,33(7):176-181.
[27]刘宝强,熊理然,蒋梅英,等.云南沿边地区县域经济的空间格局演化分析[J].地域研究与开发,2017,36(3):29-35.
[28] BRUNSDON C,FOTHERINGHAM A S,CHARLTON M E. Geographically Weighted Regression:A Method for Exploring Spatial Nonstationarity[J]. Geographical Analysis,1996,28(4):281-298.
[29]尹上岗,宋伟轩,马志飞,等.南京市住宅价格时空分异格局及其影响因素分析——基于地理加权回归模型的实证研究[J].人文地理,2018,33(3):68-77.
[30]雷慧敏,叶长盛.江西省人口老龄化县域差异及其影响因素[J].地域研究与开发,2016,35(2):170-174.
[31]常芳,杨矗,王爱琴,等.新农保实施现状及参保行为影响因素——基于5省101村调查数据的分析[J].管理世界,2014(3):92-101.
[32]刘可文,曹有挥,肖琛,等.国家区域政策对央企空间布局的影响[J].地理研究,2012,31(12):2139-2152.
[2]董晔,安瓦尔·买买提明.城镇化进程中乌鲁木齐市少数民族农民工空间分布及生存状态研究[J].地理科学,2014,34(8):963-970.
[3]岳经纶,李晓燕.社会视角下的流动人口健康意识与健康服务利用——基于珠三角的研究[J].公共管理学报,2014,11(4):125-135.
[4] LEVECQUE K,LODEWYCKX I,VRANKEN J. Depression and Generalised Anxiety in the General Population in Belgium:A Comparison between Native and Immigrant Groups[J]. Journal of Affective Disorders,2007,97(1/2/3):229-239.
[5] LINDERT J,SCHOULER-OCAK M,HEINZ A,et al. Mental Health,Health Care Utilisation of Migrants in Europe[J].European Psychiatry,2008,23(1):14-20.
[6]罗小琴,桂江丰.流动人口参加城镇职工医疗保障的行为及成因分析[J].人口与发展,2014,20(6):43-50.
[7]朱宇.国外对非永久性迁移的研究及其对我国流动人口问题的启示[J].人口研究,2004,28(3):52-59.
[8]蔚志新.流动人口社会保险参与状况的地区差异分析——基于2011年全国32个省级单位的流动人口问卷调查[J].人口学刊,2013,35(2):81-89.
[9]秦立建,惠云,王震.流动人口的社会保险覆盖率及其影响因素分析[J].统计研究,2015,32(1):68-72.
[10]石人炳,陈宁.城-城流动人口养老保险参保影响因素研究——基于全国流动人口动态监测数据的分析[J].人口研究,2015,39(4):102-112.
[11]施佳华,李娜,尹清菊,等.上海市外来务工人员医保参保现状及影响因素分析[J].医学与社会,2017,30(3):51-54.
[12]刘冬梅,王晖,龚双燕,等.中国流动人口重复参加基本医疗保险现状及影响因素[J].中国公共卫生,2016,32(1):62-65.
[13]李红娟,杨菊花.流动人口城镇职工医疗保险水平的区域差异研究[J].人口与社会,2017,33(3):3-12.
[14] JENSEN H H,SAUPE W E. Determinants of Health Insurance Coverage for Farm Family Households:A Midwestern Study[J]. North Central Journal of Agricultural Economics,1987,9(1):145-155.
[15] BARRETT G F,CONLON R. Adverse Selection and the Decline in Private Health Insurance Coverage in Australia:1989—1995[J]. Economic Record,2003,79(246):279-296.
[16] CHENG Z,NIELSEN I,SMYTH R. Access to Social Insurance in Urban China:A Comparative Study of Ruralurban and Urban-urban Migrants in Beijing[J]. Habitat International,2014,41:243-252.
[17] KARL J B,BORN P H,VISCUSI W K. The Relationship between the Markets for Health Insurance and Medical Malpractice Insurance[J]. Applied Economics,2016,48(55):5348-5363.
[18] SHI J L. Efficiency in Plan Choice with Risk Adjustment and Risk-based Pricing in Health Insurance Exchanges[J]. Geneva Papers on Risk and Insurance:Issues and Practice,2017,42(1):79-113.
[19] CAMERON A C,TRIVEDI P K,MILNE F,et al. A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia[J]. The Review of Economic Studies,1988,55(1):85-106.
[20]唐丹.流动人口参加工伤保险影响因素的定量分析——以北京、绍兴、东莞为例[J].人口研究,2011,35(5):36-44.
[21]刘志军,王宏.流动人口医保参保率影响因素研究——基于全国流动人口动态监测数据的分析[J].浙江大学学报(人文社会科学版),2014,44(5):161-174.
[22]张香玲,李小建,朱纪广,等.河南省农业现代化发展水平空间分异研究[J].地域研究与开发,2017,36(3):142-147.
[23]张耀军,任正委.基于地理加权回归的山区人口分布影响因素实证研究——以贵州省毕节地区为例[J].人口研究,2012,36(4):53-63.
[24] ANSELIN L. Spatial Externalities,Spatial Multipliers and Spatial Econometrics[J]. International Regional Science Review,2003,26(2):153-166.
[25] GETIS A,ORD J K. The Analysis of Spatial Association by Use of Distance Statistics[J]. Geographical Analysis,1992,24(3):189-206.
[26]李在军,管卫华,蒲英霞,等.山东省旅游经济的时空演变格局探究[J].经济地理,2013,33(7):176-181.
[27]刘宝强,熊理然,蒋梅英,等.云南沿边地区县域经济的空间格局演化分析[J].地域研究与开发,2017,36(3):29-35.
[28] BRUNSDON C,FOTHERINGHAM A S,CHARLTON M E. Geographically Weighted Regression:A Method for Exploring Spatial Nonstationarity[J]. Geographical Analysis,1996,28(4):281-298.
[29]尹上岗,宋伟轩,马志飞,等.南京市住宅价格时空分异格局及其影响因素分析——基于地理加权回归模型的实证研究[J].人文地理,2018,33(3):68-77.
[30]雷慧敏,叶长盛.江西省人口老龄化县域差异及其影响因素[J].地域研究与开发,2016,35(2):170-174.
[31]常芳,杨矗,王爱琴,等.新农保实施现状及参保行为影响因素——基于5省101村调查数据的分析[J].管理世界,2014(3):92-101.
[32]刘可文,曹有挥,肖琛,等.国家区域政策对央企空间布局的影响[J].地理研究,2012,31(12):2139-2152.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |