山东省某县新型农村合作医疗重大疾病医疗保险基金补偿评价研究  

Evaluation Study on Fund Compensation of the Critical Illness Insurance under New Rural Cooperative Medical System from a County of Shandong

作　　者：许建强[1] 郑娟[1] 李佳佳[1] 徐凌忠[1] 

机构地区：[1]山东大学公共卫生学院,济南250012

出　　处：《中国卫生经济》2015年第5期40-42,共3页Chinese Health Economics

基　　金：国家自然科学基金青年项目(71303137)

摘　　要：目的:分析山东省某县新农合大病保险基金补偿使用情况及效果。方法:运用Stata 12.0对大病保险补偿患者的医疗费用及补偿情况进行统计分析。结果:大病保险基金防止家庭灾难性卫生支出的成本效果较高,但基金补偿在不同年龄组人群、大病病种、家庭灾难性卫生支出发生率方面具有显著差异。结论:在按病种补偿机制不变条件下,建议大病医疗保险按年龄别和疾病别划分不同补偿比例,实施"分档补偿"。Objective:To analyze the compensation benefit of catastrophic medical insurance fund under new rural cooperativemedical system from a county of Shandong.Methods:Using Stata 12.0 Software to make statistic analysis on the medical costs andcompensation status of patients who are compensated by catastrophic medical insurance.Results:The cost effectiveness of critical ill-ness insurance to avoid families catastrophic health expenditure was better,but the catastrophic medical insurance fund beneficiarieshad vary significances in different age groups,disease groups and family catastrophic health expenditure incidence.Conclusion:Withthe same pay for disease compensation mechanism,it was suggested that catastrophic medical insurance should be divided into differ-ent compensation levels by ages and diseases,so as to implement the 'compensation by files'.

关 键 词：新型农村合作医疗 重大疾病保险 保险基金 家庭灾难性卫生支出 山东 

分 类 号：R197.1[医药卫生—卫生事业管理] F842.684[医药卫生—公共卫生与预防医学] F323.89[经济管理—保险]