大病保险制度对城乡居民家庭灾难性卫生支出的影响——基于某市调查数据的分析  

Analyzing the influence of critical illness insurance system on household catastrophic health expenditure of urban and rural residents based on survey in one city

作　　者：王超群[1] 刘小青[1] 刘晓红[2] 顾雪非[3] 

机构地区：[1]中国人民大学公共管理学院社会保障研究所,北京100872 [2]南京农业大学公共管理学院 [3]卫生部卫生发展研究中心

出　　处：《中国卫生事业管理》2014年第6期433-436,456,共5页Chinese Health Service Management

基　　金：中国人民大学科学研究基金(中央高校基本科研业务费专项资助)项目"我国新型农村合作医疗制度治理结构研究"(编号:13XNH047)

摘　　要：目的:评估大病保险制度对某市城乡居民家庭灾难性卫生支出发生率及其严重程度的影响。方法:利用该市城乡居民医疗负担调查数据,测算在不同保障程度下该市城乡居民家庭灾难性卫生支出的发生率、平均差距、相对差距和集中指数。结果:大病保险制度对该市城乡居民家庭灾难性卫生支出影响较弱。这与大病保险制度由谁经办无关,主要是大病保险制度设计本身存在问题。建议:优先扩大基本医疗保险保障范围和报销比例,因时因地调整灾难性卫生支出的标准,调整大病保险主要参量(尤其是起付线),试点全部基本医疗保险业务委托商业医疗保险机构经办,探索建立多元保险人制度。Objective To evaluate the influence of critical illness insurance system on household catastrophic health expenditure of urban and rural residents. Methods Based on the survey of health expenditure burden of urban and rural residents in one city, indexes of incidence of catastrophic health expenditure, mean catastrophic payment differences, relative gap and concentration index were calculated. Results The critical illness insurance system didn＇ t have significant influence on household catastrophic health expenditure of urban and rural residents in this city,which was mainly related with the system design. Suggestions It was suggested to expand the scope of basic medical insurance, adjust the standard of household catastrophic health expenditure and main parameters of critical illness insurance system, especially the payment line, pilot to entrust basic medical insurance to commercial health insurance agency, and explore the multi-insurer system.

关 键 词：大病保险制度 家庭灾难性卫生支出 影响评估 

分 类 号：R197.1[医药卫生—卫生事业管理]