CAJ | 학술논문

因为就业单位不缴或欠缴医疗保险费而被迫无法纳入医疗保险体系的城镇职工在本文中被称为“医保夹心层”。本文利用国务院关于城镇居民基本医疗保险试点评估调查2007--2009年的跟踪调查微观数据，研究了医保夹心层人群的健康及其医疗服务利用情况。研究发现，在控制了个人特征、就业状况、保险状态以及家庭经济状况后，医保夹心层职工的健康状况较差；其无保险状态会直接影响医疗服务利用，这表现为医保夹心层更少接受住院服务（但在门诊服务方面没有差别），但一旦住院，夹心层住院花费及其负担都会更重；其次，医疗保险状态还会影响健康意识，这表现为夹心层人群在了解医疗保健知识、定期身体健康检查方面缺乏积极性。
인위취업단위불격혹흠격의료보험비이피박무법납입의료보험체계적성진직공재본문중피칭위“의보협심층”。본문이용국무원관우성진거민기본의료보험시점평고조사2007--2009년적근종조사미관수거，연구료의보협심층인군적건강급기의료복무이용정황。연구발현，재공제료개인특정、취업상황、보험상태이급가정경제상황후，의보협심층직공적건강상황교차；기무보험상태회직접영향의료복무이용，저표현위의보협심층경소접수주원복무（단재문진복무방면몰유차별），단일단주원，협심층주원화비급기부담도회경중；기차，의료보험상태환회영향건강의식，저표현위협심층인군재료해의료보건지식、정기신체건강검사방면결핍적겁성。
Sandwich class refers to urban employed or retired workers that are not insured because their employers did not pay medical insurance premium, and according to our estimates, there are tens of millions of sandwich workers in Urban China. This paper uses an individual panel dataset tracking the medical insurance of urban residents and focuses on the health status and utilization of medical services of the sandwich class. After controlling for individual attributes, employment status, insurance status, and household demographic variables, we find that, compared with insured workers, the sandwich class self-report worse health situation; The sandwich classes receive less in-hospital services, pay more hospital costs, and feel heavier burden of medical costs; They are less likely to actively learn health and medical care information, and are less likely to have preventive physical examinations.