湖南三县新型农村合作医疗对农村居民灾难性卫生支出的影响  

The Impact of New Rural Cooperative Medical System on Catastrophic Health Payment of Rural Residents in 3 Counties of Hunan

作　　者：靖瑞锋[1] 王小万[2] 崔月颖[2] 冯芮华[2] 冯晶晶[1] 刘双梅[1] 李建[2] 

机构地区：[1]北京协和医学院中国医学科学院医学信息研究所,北京100730 [2]中国医学科学院卫生政策与管理研究中心,北京100020

出　　处：《中国卫生经济》2014年第2期48-50,共3页Chinese Health Economics

基　　金：联合国儿童基金会项目(YH702-1.1.15)

摘　　要：目的:评估新型农村合作医疗补偿对农村居民灾难性卫生支出的影响。方法:分析新型农村合作医疗补偿前后疾病经济风险和灾难性卫生支出的变化情况。结果:新型农村合作医疗报销前后,农村居民处于中高疾病风险的比例由8.25%下降到6.75%;在40%的标准下,报销前后灾难性卫生支出的发生率分别为16.50%和13.50%、灾难性支出差距分别为5.14%和3.63%、灾难性支出相对差距分别为31.16%和26.89%、集中指数分别为-0.3152和-0.3259。结论:低收入家庭疾病经济风险和灾难性卫生支出发生率较高;灾难性卫生支出的相对差距较高;新型农村合作医疗需要进一步提高补偿方式公平性;综合应用家庭经济风险和灾难性卫生支出评价家庭医疗支出更科学合理。Objective：To evaluate the effects of New Rural Cooperative Medical System（NCMS） on catastrophic health payment of rural residents. Methods ：Compare the changing of family risk（FR） and catastrophic health expenditures（CHP） before and after compensation of NCMS. Results： The rate of residents in middle and high FR reduce from 8.25% to 6.75% after the compensation of NCMS. The rates of catastrophic health payment headcount are 16.50% and 13.50%, catastrophic payment gaps are 5.14% and 3.63% before and after the compensation of NCMS. Mean positive gaps are 31.16% and 26.89%, concentration indexes of catastrophic payment headcount are-0.315 2 and-0.325 9 respectively. Conclusion： Low-income families face higher FR and CHP; the mean catastrophic payment gaps are high; NCMS needs to improve the fairness of compensation method; the comprehensive application of FR and CHP help to make more scientific and reasonable evaluation on family health expenditure.

关 键 词：灾难性卫生支出 疾病经济风险 新型农村合作医疗 湖南 

分 类 号：R197.1[医药卫生—卫生事业管理]