《保险研究》20241106-《中国居民商业医疗保险参与的年龄、时期和世代效应》（王本科、朱铭来）

［摘   要］商业医疗保险参与不足是健全多层次医疗保障体系面临的重要挑战。本文利用2008～2021年中国综合社会调查（CGSS）的8期数据，通过构建HAPC-CCREM模型和APC-I模型，分离了我国居民商业医疗保险参与的年龄、时期和世代效应。研究结果表明：我国居民商业医疗保险参与存在显著的年龄效应，商业医疗保险参与和年龄呈现“倒U型”关系；随着时期推进，居民拥有商业医疗保险的比例总体呈现上升趋势，支持政策的完善和移动互联网的发展是促进参保率提升的重要因素，基本医保对商业医疗保险参与的影响存在地区异质性；商业医疗保险参与存在显著的世代差异，不同世代因受到其经历的重大社会变动和生活经历的影响，形成不同的参与特征；异质性分析显示，城乡居民在商业医疗保险参与比例方面的差距会随着年龄增加而扩大，不同世代间商业医疗保险参与比例的变化轨迹也存在城乡差异。

［关键词］商业医疗保险；年龄效应；时期效应；世代效应

［基金项目］国家社会科学基金一般项目“延迟退休背景下中国特色代际支持模式及影响研究”（23BRK015）。

［作者简介］王本科，南开大学金融学院博士研究生，研究方向：卫生经济与医疗保障；朱铭来（通讯作者），南开大学卫生经济与医疗保障研究中心主任，南开大学金融学院教授，博士生导师，研究方向：卫生经济与医疗保障。

Age,Period,and Cohort Effects on Participation in Commercial Health Insurance Among the Chinese Residents

ZHU Ming-lai,WANG Ben-ke

Abstract：Insufficient participation in commercial health insurance is an important challenge in building a well-functioning multi-tiered healthcare security system.This paper utilizes data from eight waves of the Chinese General Social Survey (CGSS) from 2008 to 2021 and constructs HAPC-CCREM and APC-I models to disentangle the age,period,and cohort effects on Chinese residents’ participation in commercial health insurance.The study reveals the following findings:First,there is a significant age effect on participation in commercial health insurance,with an inverted U-shaped relationship between age and participation.Second,the proportion of residents with commercial health insurance has generally increased over time,with the improvement of supportive policies and the development of mobile  Internet being key factors in boosting participation rates.The impact of basic medical insurance on commercial health insurance varies across regions.Third,there are significant generational differences in commercial health insurance participation,with different generations being influenced by major social changes and life experiences,resulting in distinct patterns of participation.Fourth,the heterogeneity analysis shows that the disparity in participation between urban and rural residents increases with age and follows different generational trajectories.

Key words：commercial health insurance;age effect;period effect;cohort effect