国民健康保険料(税)の深刻な滞納者への資格証明書交付は受診抑制に繋がるおそれが指摘されているが, その交付基準は市町村によって異なる。そこで本稿では, 資格証明書交付世帯割合の決定要因を分析し, 保険料収納率を統御したうえで, 市町村の財政状況による有意な影響があることを観察した。財政状況が厳しい自治体ほど, 資格証明書の積極的な交付により医療アクセスの阻害が生じている可能性があり, そのような問題の生じない形で資格証の運用基準の統一を図る必要がある。
While the risk of medical restraints in issuing eligibility certification cards to serious delinquents of national health insurance (tax) has been highlighted, the eligibility criteria differs from one municipality to another. 
In this regard, this study analyzes the determinants of eligibility certification cards issued per household ratios, examining relevant influences from local public finance conditions, after controlling for insurance fee levy rates. 
The more stringent the municipality finance conditions, the greater is the possibility of hurdles to access to health care due to a possibly proactive issuing of eligibility certification cards; an attempt at unifying the eligibility certification management standards is necessary to avoid these types of problems.

小特集 : 格差・貧困政策に関する総合的研究