广州市社会医疗保险制度的公平性研究  

Equity Research in Guangzhou Social Health Insurance System

作　　者：陈翔[1] 王小丽[1] 

机构地区：[1]广州医学院人文社会科学学院,广州510182

出　　处：《中国卫生经济》2011年第6期21-23,共3页Chinese Health Economics

基　　金：广东省哲学社会科学"十一五"规划2010年度学科共建项目(GD10XZX01);广州市教育局市属高校科研项目(10A306);广州市医学伦理学重点研究基地成果(穗社规办[2008]11号)

摘　　要：在社会调查和相关统计资料的基础上,从独立统筹区之间参保、医保制度之间待遇水平、参保人与全人群之间卫生服务利用、医患道德风险行为影响等4个方面,评价广州市社会医疗保险制度的公平性状况。针对公平性建设中的不足,提出几点合理化建议:继续扩大社会医疗保险的覆盖面,加快医保制度之间的统筹协调发展步伐,推行以预付制为主的医方补偿机制,确定合理的医疗费用患方分担机制。Based on social surveys and relevant statistics, the equity of Guangzhou social health insurance （SHI） system is evaluated from four areas, including the insurance coverage among independent districts, the level of treatment between insurance system, utilization of health services between insured and all groups and the moral hazard behavior of doctors-patients. On the basis of equity construction, suggestions are as follows： expanding the coverage of SHI, accelerating the co-ordination development pace of insurances, adopting prospective payment system and determining a reasonable consumer＇s cost-sharing mechanism.

关 键 词：广州市 社会医疗保险 公平 

分 类 号：F842.6[经济管理—保险] R197.1[医药卫生—卫生事业管理]