西安交通大学学报（社会科学版）2025，Vol.45Issue(4)：92-103,12.DOI:10.15896/j.xjtuskxb.202504008
中国医疗制度改革与家庭财务杠杆率
Healthcare System Reform in China and Household Financial Leverage Ratio:A Perspective from Health Economics
摘要
Abstract
In the context of deleveraging,although the growth rate of leverage ratio in China's real economy sector has significantly slowed down,the leverage ratio in the household sector continues to rise.It is generally believed that household financial leverage can alleviate household liquidity constraints and achieve maximum utility,but the rapid accumulation of household leverage may bring economic or financial risks.Therefore,the issue of household leverage has received widespread attention.It can be noted that the increase in medical expenses caused by health risks directly affects household cash flow,which often becomes one of the reasons for the increase in household financial leverage.Therefore,reducing family health risks is an important way to alleviate family leverage pressure. A sound medical system is conducive to alleviating family health risks and thereby reducing family leverage.However,existing research focuses more on the effectiveness of the new healthcare reform policy,and there is relatively little literature on the pilot policies of comprehensive healthcare reform,and there has not yet been any research on the impact on families.Meanwhile,research on family leverage mainly focuses on two aspects:macro environment and family characteristics,and there is not much research on the impact of external policy shocks on it.Therefore,from the perspective of health economics,this paper takes the implementation of comprehensive medical reform policies as a natural experiment to explore the role and impact mechanism of comprehensive medical reform policies on household financial leverage. Firstly,based on relevant theories and existing facts,we condense four main theoretical hypotheses:(1)The implementation of comprehensive healthcare reform policies has reduced household financial leverage.(2)The comprehensive healthcare reform policy reduces household financial leverage by reducing household medical expenses.(3)The comprehensive healthcare reform policy affects the financial leverage ratio of households by improving their health status.(4)The comprehensive healthcare reform policy affects household financial leverage by changing family risk attitudes.Secondly,we use China Family Panel Studies(CFPS)panel data from 2010 to 2020 and empirically validate the four hypotheses using the double difference method and mechanism testing.The conclusion of this paper remains unchanged after multiple tests.In terms of heterogeneity,we found that the inhibitory effect of comprehensive healthcare reform policies on household financial leverage is more pronounced in urban households,households with optimistic expectations,low-income households,households with higher levels of aging,and households without a digital divide.Finally,we conclude that a sound medical system is beneficial for alleviating family health risks and thereby reducing household leverage.In order to fully leverage the role of the medical system in household financial leverage,we should promote further development of medical system reform,improve the convenience and reliability of medical and health services,improve the medical security system,and further reduce the pressure on household medical expenses. Compared with existing literature,this paper has two contributions.On the one hand,from the perspective of health economics,this paper explores the impact mechanism of comprehensive healthcare reform on household financial leverage ratio,expands the research perspective in the field of household economics,and helps to deeply understand the influencing factors and characteristics of household economic behavior.On the other hand,this paper introduces a double difference model to comprehensively examine the impact of comprehensive healthcare reform policies on household financial leverage.This research system can better observe the micro effects of comprehensive healthcare reform policies,providing more basic and direct evidence for evaluating policy effects.It also helps to examine the gains and losses of healthcare reform policies from a family perspective and promote further deepening of healthcare system reform.关键词
医疗制度/健康风险/综合医改政策/家庭医疗支出/家庭财务杠杆率/健康经济学Key words
medical system/health risks/comprehensive healthcare reform policies/family medical expenses/household financial leverage ratio/health economics分类
管理科学引用本文复制引用
逯进,张倬赫,苏妍..中国医疗制度改革与家庭财务杠杆率[J].西安交通大学学报（社会科学版）,2025,45(4):92-103,12.基金项目
山东省重点研发计划(软科学)重大项目(2023RZA02012). （软科学）
