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To choose the urban employee basic medical insurance and the urban and rural labor force basic medical insurance will both have a positive moderating effect on the relationship between non-agricultural employment and rural labor force consumption, while choosing the new rural cooperative medical insurance will have a negative moderating effect. As for different regions and different age groups, to choose the different types of basic medical insurance will have different effects on the relationship between non-agricultural employment and rural labor force consumption. The choice of the basic medical insurance for urban employees by rural labor force will positively promote the impact of non-agricultural employment on the upgrading of consumption structure. Therefore, it is proposed to strengthen the guarantee of non-agricultural employment for rural labor force, increase the participation rate of rural labor force in non-agricultural employment, and promote the coordinated development of the basic medical insurance systems among the regions. It is necessary to explore the consumption potential of rural labor force, and promote the upgrading of rural consumption, so as to better promote the implementation of the rural revitalization strategy and provide reference to the construction of a new development pattern of“dual circulation”. Reference | Related Articles | Metrics | Comments（0） Select The Paid Contract Services of Family Doctors and the Public Healthcare Behavior: From the Perspective of Medical-Prevention Integration LI Zi-hao Journal of Jiangxi University of Finance and Economics    2024, 0 (4): 73-86.   Abstract （20）            Knowledge map    Save The family doctor signing system is an important foundation for the supply of integrated medical and preventive services. This study uses the data from the China Health and Elderly Care Tracking Survey 2018 to investigate the mechanism of paid family doctor signing services on public medical behavior and choice. The findings of this paper show that from the perspective of medical service utilization, paid family doctor contract services can effectively promote their medical service utilization behaviors, and the improvement effect on outpatient behavior is stronger than that on hospitalization. From the perspective of medical expenses, participating in paid contracts can significantly reduce residents’ self payment expenses for medical. From the perspective of grassroots first visit behavior, paid family doctor contract services can effectively regulate resident hospitalization behaviors in grassroots first visits, but have no significant improvement effect on outpatient services. From the perspective of the impact mechanism, medical service satisfaction plays a mediating role in the mechanism of paid contract signing on hospitalization behavior, but does not affect outpatient behavior. From the perspective of accessibility to medical resources, both outpatient and inpatient medical distances can positively moderate the impact of paid contracts on medical out-of-pocket expenses, while only a negative moderating effect of inpatient medical distance is found in the impact on grassroots first visit behavior. Based on the above findings, this article suggests relying on paid contract services to improve the utilization level of medical services, strengthen the capacity of grassroots medical and health services, include paid contracts in medical insurance to further reduce patient self payment costs, and improve the accessibility and public satisfaction of grassroots medical and health services. Reference | Related Articles | Metrics | Comments（0） Select A Study on the Impact of Pension Insurance Benefits on the Service Pricing of Private Elderly Care Institutions LI Quan-lun, XIA Xue-qing Journal of Jiangxi University of Finance and Economics    2024, 0 (3): 49-63.   Abstract （41）            Knowledge map    Save By making use of the data from “An-yang-bang”platform in 2022 and China Health and Retirement Longitudinal Study in 2018, this paper estimates the impact of the improvement of the basic pension benefits of urban workers on the prices of elderly care services of private institutions. The findings show that an average increase of 1% in the basic pension benefits of urban workers would result in an increase of 0.48% and 0.36% in the minimum and maximum prices of the elderly care services of the private institutions, respectively. The increase of the pension benefits would increase the demand for institutional care services for the elderly in urban areas, which in turn increases the price of private institutional care services. In addition, the increase of the pension benefits will have a greater impact on the prices of private institutions that are larger, located in central urban areas, and operating for a shorter time. The reform of the elderly care service system can be promoted by establishing pricing guidelines for private elderly care institutions, integrating pension insurance benefits with elderly care service policies, and optimizing subsidy mechanisms for private elderly care institutions, so as to facilitate the sustainable development of these institutions. Reference | Related Articles | Metrics | Comments（0） Select Long-Term Care Insurance Policy: Essential Characteristics, Implementation Effect and Overflow Effect Based on the Investigation of the Pilot City of Z District in Nantong SU Hui, WANG Lin, LIU Hua Journal of Jiangxi University of Finance and Economics    2024, 0 (3): 64-77.   Abstract （58）            Knowledge map    Save Based on the survey and interview data of Z District in Nantong, which is among the first batch of pilot cities in China, this paper investigates the implementation effect of the long-term care insurance policy. The findings show that the long-term care insurance policy can provide economic support for the disabled elders and their families through the way of social aid; at the same time by perfecting the care service system, this policy can help the families of the disabled elders to turn their economic supports into care services to a certain extent, thereby achieving its basic policy objectives. For now, however, the utilization rate of the long-term care insurance policy is still low, and the release of the family labor force is limited, especially in rural areas. At the same time, the long-term care insurance policy has the spillover effect of promoting the development of the pension industry and promoting the optimal allocation of medical insurance resources to a certain extent. In the future policy implementation, the richness and practicability of the home service content should be increased, while the duration and frequency of service should be increased. The government should gradually reduce the intervention in the elderly service market, and introduce a benign market competition mechanism, so as to promote the improvement of the pension service level. Reference | Related Articles | Metrics | Comments（0） Select A Study on the Impact of Social Pension Insurance on the Physical and Mental Health of the Elderly JIANG Sheng-zhong, GUO Xiu-qi, YAN Shu-han, WANG Jia-lu Journal of Jiangxi University of Finance and Economics    2024, 0 (2): 41-55.   Abstract （87）            Knowledge map    Save Based on the data from the 2018 China Health and Retirement Longitudinal Study, this paper uses the multiple linear regression model to empirically analyze the relationship between whether or not to enroll in social pension insurance and the amount of pension and the physical and mental health of the elderly. It also incorporate life satisfaction, preventive medical service utilization and social activities as mechanism variables into the analytical frameworkto specifically analyze the internal mechanisms through which social pension insurance affects the health of the elderly. The findings show that whether or not to participate in social pension insurance has little effect on the health status of the elderly, while the level of pension has a significant positive relationship with the health level of the elderly. The pension level can enhance the health of the elderly through the improvement of life satisfaction, the preventive medical service utilization and the social activities. Further research reveals that the pension level has a more pronounced effect on the mental health of the urban elderly. In view of this, it is recommended to improve the social pension insurance system, steadily raise the level of pension benefits, and pay attention to the construction of the supporting system for pension services, so as to strengthen the role of social pension insurance in promoting the health of the elderly. Reference | Related Articles | Metrics | Comments（0） Select The Influence of Resident Medical Insurance Outpatient Coordination on Doctor-Patient Behaviors DING Shao-qun, ZHOU Yu-xuan Journal of Jiangxi University of Finance and Economics    2024, 0 (2): 56-68.   Abstract （53）            Knowledge map    Save The reform of outpatient coordination of the medical insurance plays a key role in optimizing the order of patients’ medical care and guiding the functional positioning of hospitals. This study adopts thedistrict and county data of the urban and rural residents’ health insurance outpatient coordination from 2008 to 2021 in 21 prefectural cities and states in Sichuan Province and matches them to the local mesoscopic data in the Wind Database to empirically test the impact of the outpatient coordination reform on the residents’ choice of medical treatment and the treatment behaviors of the medical institutions with the progressive double-difference method. The findings show that the outpatient coordination reform has reduced the proportion of hospital consultations and admissions by 1.3% and 1.8% respectively, while the proportion of the consultations and admissions in the primary health care institutions has increased by 1.4% and 1.8% respectively. The reform has led to a 2.4% increase in the rate of inpatient surgery in public hospitals, while the number of bed days and the bed utilization rate have dropped significantly, and the outpatient coordination has led to a further reorganization of the functions of public hospitals. It is recommended that the allocation of primary medical care resources be further strengthened, that public hospitals be monitored for their treatment practices, and that the experience of building close-knit medical communities be promoted as soon as possible. Reference | Related Articles | Metrics | Comments（0） Select A Study on the Reasonable Growth Mechanism of Urban and Rural Residents’ Basic Pension: Taking Jiangsu Province as an Example CAO Si-yuan, LIN Min-gang Journal of Jiangxi University of Finance and Economics    2024, 0 (1): 54-68.   Abstract （77）            Knowledge map    Save In the context of the high-quality social security development, the basic pension scheme for urban and rural residents is faced with such major problems as lower security levels,undecided benefits determination, inadequate regular adjustment mechanisms, etc.. Taking Jiangsu Province as an example, this paper measures the lower and the upper limits of the reasonable insurance level for theurban-rural pension system. The calculation shows that the lower limit of the reasonable insurance level for 2016-2020 is between 611.71 yuan/month and 771.00 yuan/month, and the upper limit is between 880.34 yuan/month and 1239.37 yuan/month. Therefore, the lower and upper limits of the reasonable replacement rate are determined at 40.73% and 60.97%, respectively. After comparing with the actual value, it is found that the lower limit of the reasonable insurance level far exceeds the lower limit of the actual insurance level. After the strong intervention of the compensation standard raising measures, it is estimated that the higher value of the insurance level may exceed the upper limit of the reasonable insurance level. To this end, specific improvement plans are proposed from the two main aspects: improving the payment level to a reasonable range and establishing a basic pension index adjustment mechanism. It is suggested, based on different payment years, to set a lower limit of 2704~4656 yuan/year and an upper limit of 4441~7504 yuan/year for the higher reasonable payment range and a lower limit of 542~2142 yuan/year and an upper limit of 2279~7504 yuan/year for the lower reasonable payment range. It is recommended to jointly determine the adjustment range of basic pension index benefits with 60% of the annual CPI and 100% of the per capita disposable income growth rate of rural residents. Reference | Related Articles | Metrics | Comments（0） Select The Influence of Horizontal Differences of Local Financial Resources on the Equalization of Social Security Expenditure REN Bin, LIN Yi Journal of Jiangxi University of Finance and Economics    2024, 0 (1): 69-82.   Abstract （36）            Knowledge map    Save Optimizing social security expenditures by governments at all levels is an important task in promoting the equalization of basic public services, and the reasonable allocation of expenditure responsibilities must be based on the government financial resources. Based on the data of 25 provinces and 243 prefecture-level cities, this paper adopts the relational data analysis paradigm to conduct an empirical study of the impact of the horizontal differences in local financial resources on the equalization of social security expenditures. The findings show that, firstly, the horizontal difference of financial resources has an inhibitory effect on the equalization of social security expenditure at both provincial and prefecture-level cities, and it is stronger at the prefecture-level city level. Secondly, at the provincial level, this effect is manifested at the provincial level as an increasing trend in the central, western, and eastern regions; on the contrary, at the level of prefecture level cities, it shows an increasing trend in the eastern, western, and central regions. Thirdly, whether at the provincial level or prefecture level, the structure of government fiscal expenditure and the central government supervision of social security are important intermediary factors that affect the equalization of social security expenditures due to horizontal differences in financial resources. Based on this, to promote the equalization of social security expenditure in China, the state needs to strengthen the horizontal adjustment of local financial resources and optimize the "hierarchical" design of the equalization top-level system, as well as improve the central transfer payment mechanism. Reference | Related Articles | Metrics | Comments（0） Select The Impact of Long-Term Care Insurance on the Financial Burden of Medical Insurance for Urban and Rural Residents: From the Regional Perspective and Based on Substitution Effect TANG Wei, YU Xing-ran, SU Fang Journal of Jiangxi University of Finance and Economics    2023, 0 (6): 40-55.   Abstract （83）            Knowledge map    Save With the deepening of population aging and the increase in medical expenses, the ability of urban and rural residents to pay for medical insurance has weakened, and the financial pressure has been increasing year by year. In order to reduce the personal payment burden, some pilot areas of long-term care insurance adopted a financing method of relying on medical insurance fund transfer during the initial implementation of the system. If this financing method continues, what impact will it have on the financial burden of the medical insurance fund in the future? Based on an actuarial model of medical insurance that includes substitution effects, this paper simulates the operation of long-term care insurance funds and the medical insurance funds in various regions from 2021 to 2050. The results indicate that when the two systems operate independently, the financial burden of medical insurance will significantly increase. If the long-term care insurance relies entirely on medical insurance funds, both the current and cumulative deficits will be advanced by 6 years. If the long-term care insurance has a substitution effect on medical expenses, when the substitution factor for home care subsidies is 2.043, promoting the long-term care insurance nationwide will not have any impact on the sustainability of the medical insurance fund. Therefore, adopting a financing method that relies on the transfer of medical insurance funds during the initial operation of the system will not bring excessive financial burden, but it will help to expand the coverage rate and provide guarantee for the gradual independent operation of the long-term care insurance system. Reference | Related Articles | Metrics | Comments（0） Select Reform of the Financing and Security Mechanism for Urban and Rural Old-Age Insurance and Optimization of the Fiscal Subsidies Structure XU Ding, YANG Zai-gui Journal of Jiangxi University of Finance and Economics    2023, 0 (6): 56-67.   Abstract （74）            Knowledge map    Save According to the 14th Five-Year Plan for the development of human resources and social security undertakings, the financing mechanism of endowment insurance for urban and rural residents should be optimized, the interest calculation method of individual accounts should be standardized, and the mechanism for determining the benefits and the regular adjustment of basic pension should be fully implemented. By constructing an actuarial model, this paper examines how the comprehensive reform of the financing and safeguard mechanism of endowment insurance for urban and rural residents affects the alignment between the financial subsidy structure and the subsidy policy orientation. The findings show that coordinating and adjusting the government’s subsidy model for contributions, increasing collective subsidies, reforming individual account interest calculation methods, and increasing the number of years of basic pension can significantly improve the compatibility of subsidy structure and policy incentive orientation, and that coordinating the increase in the growth rate of basic pension and the elderly basic pension will enhance the compatibility between the subsidy structure and the policy’s inclusive orientation. The sensitivity test results are stable, and the minimum standard growth rate of basic pension, the minimum contribution grade and the accounting interest rate of individual accounts have a strong influence on the fiscal subsidy, while the other factors have a weaker influence. Reference | Related Articles | Metrics | Comments（0） Select The Impact of the Integrated Medical and Nursing Care Services in Home and Community on the Elderly Medical Expenses: Effect Measure and Mechanism Analysis SUN Ju, HAN Wen-jing Journal of Jiangxi University of Finance and Economics    2023, 0 (5): 51-64.   Abstract （73）            Knowledge map    Save Based on the data of CHARLS (2018) and with the help of the Heckman sample selection model, two-part model, treatment effect model and the causal mediation effect analysis method, this paper systematically investigates the effect, action path and heterogeneity of the integratedmedical and nursing care services in home and community on the elderly medical expenses.The results show that the integrated medical and nursing care services has significant economic performance, that is, promoting the utilization of outpatient services and reducing the probability of hospitalization. For every one unit increase in the integrated medical and nursing care services, the total hospitalization cost is reduced by about 2145 yuan. And there are significant health effects and service substitution effects, mainly through the improvement of the health level of the elderly, improving health care?behavior and medical service utilization behavior, thereby restraining the elderly medical expenditure.At the same time, theintegrated medical and nursing care services at home and in community has a more significant effect on the elderly groups who are living in rural areas, with the age not too old, with poor health, and living with spouses.Therefore, it is necessary to further improve the supply capacity and quality of the integrated medical and nursing care services, strengthen the dynamic health monitoring and behavior management of the service objects, and formulate the incentive mechanism forthe service suppliers and the preferential treatment policy for the demand side by aiming at the rural areas and the vulnerable groups. Reference | Related Articles | Metrics | Comments（0） Select Research on the Influence of Participation in Urban Workers’ Medical Insurance on the Labor Supply of Migrant Workers LI Rui, GAO Duan-yang, CHEN Chuan-bo Journal of Jiangxi University of Finance and Economics    2023, 0 (5): 65-77.   Abstract （60）            Knowledge map    Save Based on the data of China Migrants Dynamic Survey in 2017 and the matching data of 234 prefecture level cities, this paper systematically investigates the impact of urban workers’ medical insurance on the labor supply of migrant workers. The findings show that: (1) to participate in urban workers’ medical insurance will reduce the labor supply time of migrant workers and improve labor efficiency, showing an income effect and a positive labor supply effect. (2) there is obvious differentiation of labor supply effect in urban workers’ medical insurance. For migrant workers who participate inthe way of “unit+individual”, there is mainly an income effect; while for migrant workers who participate in the way of flexible employment status, there is a payment constraint; the urban workers’ medical insurance has a stronger effect on relieving the excessive work of the older generation of migrant workers. (3) the mechanism analysis reveals that health level plays a part of intermediary effect in the impact of urban workers’ medical insurance on the labor supply of migrant workers, while the consumption level plays a masking effect in the impact of urban workers’ medical insurance on the labor supply level of migrant workers. Reference | Related Articles | Metrics | Comments（0） Select The Impact of Basic Old-Age Insurance and Basic Medical Insurance on the Identification of the Flexible Employment Class ZHANG Yin-kai, ZHANG Xue, XUE Hui-yuan Journal of Jiangxi University of Finance and Economics    2023, 0 (4): 51-65.   Abstract （103）            Knowledge map    Save Based on the data from the Chinese General Social Survey (2013~2018), this study analyzes the trends of the identification of the flexible employment class and explores the heterogeneous effects of the participation in the basic old-age insurance and the basic medical insurance on the identification of the flexible employment class varied by household registration and age. The findings show that: (1) compared with traditional full-time employment, the identification of the flexible working class is relatively lower, and has widely existed characteristics of longitudinal“downward shift”, i.e., the average class identification level is lower and presents a trend of decreasing over time; (2) the participation in the basic old-age insurance has a signification positive effect on the present class identification of the flexible employment personnel, whereas the participation in the social medical insurance also has a significant positive effect on the present and expected class identification of the flexible employment personnel; (3) in the heterogeneity analysis, to participate in the social old-age insurance can significantly improve the current class identification of the middle-and old-aged flexible employment individuals, whereas to participate in the social medical insurance can significantly improve the present and expected class identification of the rural flexible employment personnel. Therefore, this paper puts forward such policy suggestions as removing the institutional barriers to the flexible workers’ participation in the social insurance, establishing and improving the payment incentive and transfer mechanism, enhancing the payment capacity of the low-income flexible workers, and improving the multi-level social security system. Reference | Related Articles | Metrics | Comments（0） Select The Impact of Social Security Expenditure on the Urban-Rural Income Gap: A Re-Examination from the Perspective of Common Prosperity XIA Hui-qin, ZHU Huo-yun Journal of Jiangxi University of Finance and Economics    2023, 0 (4): 66-77.   Abstract （101）            Knowledge map    Save From the perspective of common prosperity, this study re-examines the non-linear impact of social security expenditure on the urban-rural income gap based on the provincial panel data from 2001-2021. The results show that there is an inverted U-shaped relationship, first expanding then shrinking, between the social security expenditure and the urban-rural income gap, in which the degree of“sharing”of the social security benefits between urban and rural residents plays a mediating role. Further investigation in different regions reveals that this inverted U-shaped relationship also exists, that the inverted U-shaped curve of the central and western regions is wider, that the marginal impact effect of social security spending is greater, and that the social security expenditure at the inflection point of the curve is even more. Therefore, in order to effectively narrow the urban-rural income gap, it is necessary not only to reverse the urban bias existing in the social security expenditureand improve the degree of“sharing”of social security benefits between urban and rural residents, but also to continuously increase social security expenditure to improve the degree of“prosperity”of social security, as well as to pay attention to the adjustment of the regional bias of social security expenditure and increase the social security input in the central and western regions. Reference | Related Articles | Metrics | Comments（0） Select Industrial Catch-up and Medical Security Level: Theoretical and Empirical Research Based on the New Structural Economics YAN Hai-ning, ZHANG Gao-fei, ZHAO Qiu-yun Journal of Jiangxi University of Finance and Economics    2023, 0 (3): 57-70.   Abstract （69）            Knowledge map    Save Based on the provincial panel data of China from 2002 to 2020, this paper conducts a theoretic and empirical analysis of the relationship between industrial catch-up and medical security level. The findings show that the industrial catch-up strategy that violates the comparative advantage will limit the improvement of the level of medical security by damaging the viability of enterprises, reducing the level of medical infrastructure and expanding income inequality. The greater the degree of industrial catch-up, the lower the level of medical security, and the more significant the negative impact on the downstream provinces of the industry will be. Further research reveals that both the integration of basic medical insurance for urban and rural residents and the implementation of the “Healthy China”strategy have a significant positive effect on the level of medical security. At the same time, due to the long-term existence of the distorted costs caused by the legacy of the industrial catch-up strategy, the medical security reform has reached the“critical period”and is constantly digesting the distorted costs. Therefore, it is recommended that all the regions should implement the development strategy of dynamic comparative advantages, enhance the overall planning of medical insurance among different regions, and increase the investment in medical insurance in rural areas, so as to make the overall medical security level of China develop in a more balanced and appropriate manner. Reference | Related Articles | Metrics | Comments（0） Select The Hierarchical Influence of Social and Economic Security on the Well-Being of the Frail Elderly: The Mediating Effect of Social Status and Psychological Resilience JIANG Mao-min, TU Ai-xian Journal of Jiangxi University of Finance and Economics    2023, 0 (3): 71-81.   Abstract （80）            Knowledge map    Save In the context of increasing global population aging trend, it is of vital importance to improve the well-being of the frail elderly and create an active aging society. Based on the survey of 31 provinces of China, this paper makes use of the macro data from the“China Statistical Yearbook”and“China Health Statistical Yearbook”from 2017 to 2021 and constructs a cross-hierarchy model (HLM) according to the social quality theory, the self-determination theory and the social class theory, so as to explore the mechanism of the influence of social and economic security on the well-being of the frail elderly. The findings show that: (1) social and economic security, social status, and personal psychological resilience all have a positive impact on the well-being of the frail elderly; (2) psychological resilience partially mediates the relationship between social and economic security and the well-being of the frail elderly, while no such mediating effect exists between social status and the well-being of the frail elderly; (3) both social and economic security and social status have a significant positive moderating effect on the relationship between psychological resilience and the well-being of the frail elderly. Reference | Related Articles | Metrics | Comments（0） Select Research on the Impact of Reducing Pension Payment Rate and Delaying Retirement on Pension Funds Adequacy LUO Qing-ju Journal of Jiangxi University of Finance and Economics    2023, 0 (2): 67-78.   Abstract （71）            Knowledge map    Save The General Office of the State Council issued The Comprehensive Plan for Reducing Social Premium Rates in 2019. This Plan explicitly cuts the unit contribution rate of basic pension insurance for urban workers to 16%, which will pose a greater challenge to the adequacy of pension insurance funds. With the help of the OLG model, this paperstudies the impact of the two policies of reducing the pension insurance contribution rate and delaying retirement on the adequacy of the pension insurance funds. The findings show that, firstly, implementing the pension insurance contribution reduction policy alone will directly lead to a significant decline of fund income in the current pooling account at the steady state period, and indirectly cause an increase in the pooling account fund expenditure and individual account fund income and expenditure through affecting the per capita capital stock and wage level at the steady state, which will exert a certain impact on the adequacy of funds. Secondly, the implementation of the delayed retirement policy alone will directly and indirectly result in a decline and then an increase in the income of the pooling account funds and the individual account funds, a significant decline in the expenditure of the pooling account funds, and a slight decline in the expenditure of the individual account funds. Thirdly, the implementation of the delayed retirement policy in the context of fee reduction will significantly reduce the challenges to the adequacy of funds brought by the fee reduction policy, and both the pooling fund gap and the total fund gap are likely to shrink to the pre-fee reduction level with the gradual delay in the retirement age. Reference | Related Articles | Metrics | Comments（0） Select The Selection Effects in China's Supplementary Medical Insurance Markets YANG Pan-xu Journal of Jiangxi University of Finance and Economics    2023, 0 (2): 79-92.   Abstract （89）            Knowledge map    Save Based on the date of China Family Panel Studies 2018, this paper chooses the Bivariate Probit model and the instrumental variable Probit model to test the correlation between health risks and insurance and to study the selection effects in the supplementary medical insurance markets. The results show that the “health risk-insurance”correlation is significantly negative in the supplementary medical markets. The groups self-assessed as relatively healthy people are more willing to participate in the supplementary medical insurance. This paper confirms the robustness of the empirical results by making a robustness analysis with the more objective proxy variables and the adjusted hospitalization costs as the proxy variables of health risks. The results of the heterogeneity analysis show thatthe health risks and risk aversion jointly make clear that the selection effect is advantageous selection in China's supplementary medical insurance markets. In the relatively immature supplementary medical insurance markets, personal information is multi-dimensional; the relative risk aversion can exert a significantly impact on the decision to participate in the supplementary medical insurance. Reference | Related Articles | Metrics | Comments（0）