测算解决特定风险所需的筹资:新型农村合作医疗保险方案研制思路之五  

Financing measurement of addressing the specific financial risk from medical expenses of the rural residents:ideas of developing NRCMS(Ⅴ)

作　　者：孙梅[1] 程佳[1] 王颖[1] 陈文[2] 吴擢春[2] 郝模[1] 

机构地区：[1]复旦大学卫生发展战略研究中心,上海200032 [2]复旦大学公共卫生学院,上海200032

出　　处：《中国卫生资源》2013年第3期162-164,共3页Chinese Health Resources

基　　金：教育部重大攻关项目(07JZD0017);国家自然科学基金项目(70733002;71003025);教育部创新团队项目(IRT0912);复旦大学"985工程"三期整体推进社会科学研究项目(2011SHKXZD020;2012SHKXQN008);上海市卫生局卫生政策研究课题(2011HP002);国家社会科学基金项目(08CZZ022)

摘　　要：在明确就医经济风险分布的基础上,通过建立"就医概率—就医费用—就医经济风险—解决特定风险人均筹资额"的定量联动关系,明确消除或降低特定风险所需的筹资额,回答了"在特定保险费率下能解决农村居民何等就医风险",解决了新农合筹资测算的技术难题。通过样本地区数据的验证,确保了测算思路和方法的可操作性。Based on the distribution of the financial risk from medical expenses, this article explicitly illustrated the funds needed to eliminate or reduce the specific financial risk, and gave answer to what medical risks could be settled under specific insurance premium and overcame the technical difficulties involved in funding measuring in the New Rural Cooperative Medical System of China, through establishing the quantitative dynamic relations of probability of hospitalization, medical expense, economic risk and per capita funding needed to address specific risk. And then, a sample data was used to ensure the feasibility of the measuring ideas and methods.

关 键 词：新型农村合作医疗 特定风险 筹资 

分 类 号：R197.1[医药卫生—卫生事业管理]