重要靶点人群社会医疗保险经济保障程度的实证研究  

Empirical Study on Economic Security Degree of Social Medical Insurance on Target Group

作　　者：付文琦[1] 张清华[2] 李宝玉[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]浙江大学医学院附属义乌医院品管部,杭州322000 [3]连云港市第一人民医院医务处,江苏连云港222002

出　　处：《中国卫生经济》2014年第2期41-42,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(12532212);联合保险经纪集团2012年度医疗卫生风险管理服务体系科研项目(LHYLFXTS201201)

摘　　要：目的:测算社会医疗保险对发生家庭灾难性卫生支出的重要靶点人群的经济保障程度。方法:采用灾难性卫生支出测算方法以及重要靶点人群社会医疗保险经济保障程度的评价方法,以新型农村合作医疗保险制度为研究对象。结果:新农合使黑龙江省农村家庭灾难性卫生支出发生率降低了11.82%,使保险补偿后免于发生灾难性卫生支出家庭的灾难性卫生支出严重程度平均降低了5.46%,使保险补偿后仍处于灾难性卫生支出家庭的这一比例降低了18.22%,保险的作用系数达到0.66。结论:新农合在减少和缓解黑龙江省农村家庭灾难性卫生支出方面起到了积极作用,但政府仍需重点关注发生严重家庭灾难性卫生支出的这部分重要靶点人群,以进一步提高保险的经济保障程度。Objective： Measure the degree of economic compensation of social medical insurance on target households which had catastrophic health expenditure. Methods： Apply the method of catastrophic health expenditure and the methodology of economic security degree of social medical insurance on target population, taking the new rural cooperative medical insurance as the research object. Results： The incidence of catastrophic health expenditure（CHE） for rural households in Heilongjiang was reduced by 11.82% under the function of New Rural Cooperative Medical System（NCMS）. The severity of CHE was alleviated by an average of 5.46% for households that eliminated catastrophe after reimbursement. For those remaining in catastrophe after reimbursement, the severity of CHE was reduced by 18.22%. The function coefficient of the NCMS on reducing the CHE was 0.66. Conclusion： NCMS had reduced and alleviated the severity of the impact of catastrophic health expenditure on rural households; however, the government still needs to focus on the important target group suffered CHE.

关 键 词：靶点人群 灾难性卫生支出 社会医疗保险 新型农村合作医疗 经济保障程度 

分 类 号：F842.6[经济管理—保险]