2015年上海市医疗救助情况及效果分析  

Analysis on the Situation and Effect of Medical Assistance in Shanghai in 2015

作　　者：李芬[1,2] 王常颖[1] 甘银艳[1] 张晓溪[1] 林婕 蔡德琪 王希 

机构地区：[1]上海市卫生和健康发展研究中心(上海市医学科学技术情报研究所),上海200040 [2]复旦大学公共卫生学院,上海200030 [3]上海市民政局救济救灾处,上海200125

出　　处：《中国卫生经济》2017年第11期29-31,共3页Chinese Health Economics

基　　金：上海市民政局科研项目(4-1-07)

摘　　要：目的:梳理上海市基本医疗保障制度、救助政策的制度,救助对象的实际医疗费用负担以及救助实施效果。方法:利用上海市民政局救助数据分析救助对象医疗费用负担、医疗救助效果和救助前后灾难性卫生支出发生情况。结果:2015年,上海市医疗救助对象的人均医疗费用17 344元,自负费用占总医疗费用的27.37%。救助对象人均救助金额为2 276元,救助后自负费用降低了13.12个百分点。救助前发生灾难性卫生支出人数占总人数比例为36.23%,救助后发生灾难性卫生支出人数比例降为25.09%。结论:上海市医疗救助对降低自负费用作用、减少灾难性卫生支出较为明显,不同人群的救助水平有所差异。建议要实现救助对象的基本医保全覆盖,完善与基本医疗保险制度的衔接,进一步提高救助水平。Objective： To summarize the basic medical insurance, the supplementary insurance, the actual medical burden on medical assistance and the assistance implementation effects. Methods： Using the data of Shanghai Civil Affairs Bureau to analyze the burden of medical expenses, the effect of medical assistance and the occurrence of catastrophic health expenditure. Results： In 2015, the per capita medical expense of medical assistance in Shanghai was 17 344 yuan, and the patient co-payment accounted for about 27.37% of the total medical expenses. The amount of per capita medical assistant was 2 276 yuan, 13.12% of co-payment decreased. The proportion of catastrophic health expenditure before medical assistant was 36.23% and reduced to 25.09% after the assistance. Conclusion： The medical assistance was effective in reducing the co-payment and catastrophic proportion in Shanghai, but the medical assistant differed among different population groups. It was suggested all objective of medical assistant should be full covered by basic medical insurance, enhanced the convergence of medical assistant with the basic medical insurance, implemented the matching of basic medical insurance system and improved the level of medical assistant.

关 键 词：医疗救助 医疗费用负担 效果 灾难性卫生支出 

分 类 号：R197.1[医药卫生—卫生事业管理]