北京市新型农村合作医疗大病保险实施效果及基金流向研究  

Analysis on Implementation Effects of the Catastrophic Disease Insurance of the New Rural Cooperative Medical System and the Flow of Insurance Fund

作　　者：贾继荣[1] 高广颖[1] 马骋宇[1] 那春霞[1] 马千慧 段婷[1] 俞金枝 

机构地区：[1]首都医科大学卫生管理与教育学院,北京100069 [2]北京市新型农村合作医疗管理中心,北京100053

出　　处：《中国卫生经济》2016年第1期41-44,共4页Chinese Health Economics

基　　金：北京市教育委员会人文社会科学研究计划重点项目(SZ201410025008);北京市新型农村合作医疗大病保障的实施对疾病经济负担的影响研究

摘　　要：目的:评估北京市新农合大病保险制度实施效果及基金使用情况。方法:通过对北京市SY区、PG区和FS区新农合大病患者医疗负担调查数据进行分析,测算大病保险报销前后实际报销比例变化情况;从病种、医疗机构级别及经济收入水平三个维度分析大病保险基金使用情况。结果:新农合大病保险制度在一定程度上缓解了农村居民的疾病经济负担;新农合大病保险基金主要流向了二、三级医疗机构,补偿的病种比较集中,受益公平性良好。结论:新农合大病保险制度在筹资、补偿以及监管方面有待进一步完善。Objective： To evaluate the implementation effects of the catastrophic disease insurance of the New Rural Cooperative Medical System（NCMS） and the flow of the insurance fund. Methods： Collecting catastrophic disease patient data of SY District, PG District and FS District with a comparative analysis of implementation effects; measuring the changes in practical compensation ratio before and after catastrophic disease insurance reimbursement; analyzing insurance funds usage from the disease, the levels of medi- cal institutions and economic level. Results： To a certain extent, the policy of catastrophic disease insurance played an important role in releasing the economic burden on patients with catastrophic diseases in rural areas; the insurance fund flew to second-elass hospi- tals and third-class hospitals focusing on the special diseases with good beneficial equity. Conclusion： The financing, reimbursement and supervision of catastrophic disease insurance of NCMS remained to be further perfected.

关 键 词：新型农村合作医疗 大病保险 实际补偿比 北京 

分 类 号：R197.1[医药卫生—卫生事业管理] F842.684[医药卫生—公共卫生与预防医学] F323.89[经济管理—保险]