新农合大病保险制度对缓解灾难性卫生支出的效果评价  

Evaluation on the Effect of the Catastrophic Medical Expenditure Insurance for Rural Residents on Alleviating Catastrophic Health Expenditure

作　　者：高广颖[1] 马骋宇[1] 胡星宇[1] 杨显[1] 段婷[1] 贾继荣[1] 

机构地区：[1]首都医科大学卫生管理与教育学院,北京100069

出　　处：《社会保障研究》2017年第2期69-76,共8页Social Security Studies

基　　金：北京市教育委员会社科计划重点项目"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"(SZ201410025008)成果

摘　　要：本研究以北京部分区县为研究现场,选取北京市3个区县,对497名大病患者采用问卷调查的方式收集大病患者收入与支出信息,并与新农合管理中心平台中患者费用数据进行对接,结果显示:40%与50%标准下,大病保险补偿后灾难性卫生支出发生率下降百分比分别为2.21%与2.61%,40%标准下,补偿后平均差距与相对差距下降值分别为1.402%与1.052%,50%标准下为1.200%与0.977%。研究表明,新农合大病保险补偿后灾难性卫生支出发生率、差距有所下降但不明显,不同经济水平区对受益幅度影响不大,通过提高补偿比、建立精准补偿等措施,大病保险对缓解灾难性卫生支出的作用还有待制度的推进而完善。Using the typical sampling method,in accordance with the level of economic and management sector.three districts was been selected as the research fields,497 patients whose medical expenditure exceed the deductible standard was been investigated in this study,collecting the data of income and expenditures of this patient by questionnaire survey.This information is combined with the medical expenditure of the same patients from the NCMS management center platform.In this study,we used 40%and 50% double standards to calculate the catastrophic health expenditure before and after the compensation of CMEI.in the 40% and the 50% standard,the incidence rate of CMEIS before and after compensation decreased percentage were 2.21% and 2.61%.From the overall sample,in 40% standards,the average gap and the relative gap of patients after compensation were decreased 1.402%and 1.052%;in the 50% standard were 1.200%and 0.977%.CMEIS alleviate the economic burden of patients effectively,it could alleviate the ＂catastrophic health expenditure＂ to a certain extent,but the effect is not significant.Different economic levels have little effect on the real reimbursement ratio.The CMEI should be promoted further by raising reimbursement ratio and controlling the cost of the patients in the high level hospitals.

关 键 词：新农合大病保险 灾难性卫生支出 差距 评价 

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