构建重要靶点人群社会医疗保险经济保障程度的评价方法  

Building Evaluation Methodology of Economic Security Degree of Social Medical Insurance for Target Group

作　　者：付文琦[1] 李宝玉[2] 张清华[3] 刘国祥[1] 

机构地区：[1]哈尔滨医科大学公共卫生学院卫生经济教研室,哈尔滨150081 [2]连云港市第一人民医院医务处,江苏连云港222002 [3]浙江大学医学院附属义乌医院品管部,杭州322000

出　　处：《中国卫生经济》2014年第2期39-40,共2页Chinese Health Economics

基　　金：黑龙江省教育厅人文社会科学研究项目资助(12532212)

摘　　要：目的:以灾难性卫生支出家庭作为重要靶点人群,构建社会医疗保险对这部分家庭经济保障程度的评价方法,以期从一个侧面揭示社会医疗保险的实施效果。方法:采用灾难性卫生支出测算方法,通过模型和指标的构建,从四大方面研究社会医疗保险对灾难性卫生支出家庭的经济保护程度。结果:构建了针对保险报销后免于发生灾难性卫生支出的家庭、仍然发生灾难性卫生支出的家庭以及全部灾难性卫生支出家庭的保险经济保障程度系数,并构建了保险对家庭灾难性卫生支出的作用系数。结论:构建的评价指标可以用于同一保险在不同时期、不同保险在同一时期以及不同保险在不同时期的作用效果的比较分析。Objective： Taking the households with catastrophic health expenditure as target group, building the methodology of economic security degree of social medical insurance, so as to reveal the implement effect of social medical insurance. Methods： Applying the method of catastrophic health expenditure and constructing model and index from four aspects to analyze the economic security degree of social medical insurance for catastrophic health expenditure households. Results： A series of indicators for different parts of the households, including households eliminating catastrophe after reimbursement, households remaining in catastrophe after reimbursement and households trapped into catastrophe before reimbursement has been established. In addition, the intensity indicator of the integrated impact on health insurance for the households has been constructed. Conclusion： The chonstructed indicators can be used to compare the effects of the same kind of health insurance at different times, different kinds of health insurance at the same time and different kinds of health insurance at different time.

关 键 词：靶点人群 灾难性卫生支出 社会医疗保险 经济保障程度 

分 类 号：F842.6[经济管理—保险]