农村医疗救助的扶贫效果及其制约因素的实证研究——基于“国家扶贫改革试验区”丽水市的调查  

Empirical Study on the Poverty Alleviation Effect and Restricting Factors of Rural Medical Assistance in China——Based on Investigation of Lishui City Named"National Poverty Alleviation Reform Pilot Area"

作　　者：戴卫东 徐谷雄 DAI Wei-dong;XU Gu-xiong(School of Public Management,Zhejiang University of Finance and Economics,Hangzhou 310018,China)

机构地区：[1]浙江财经大学公共管理学院,浙江杭州310018

出　　处：《中国软科学》2020年第4期56-69,共14页China Soft Science

基　　金：国家社科基金重点项目(18AGL018)。

摘　　要：医保扶贫是我国当前农村精准扶贫的一项重要政策,医疗救助是医疗保障制度的最后一道“安全网”。本文以浙江省丽水市为样本,通过测算农村贫困人群在医疗救助介入前后医疗自付总费用的变化,以及构建灾难性医疗支出的相关指标来评价医疗救助扶贫的扶贫效果;并通过描述性统计与回归模型分析了个体特征、就医行为对灾难性医疗支出的影响。最后,本文从推动医疗救助方式改革,实施医疗救助专项药品目录,对农村贫困人群的政策外医疗自付费用探索补充性救助等方面提出政策建议。Poverty alleviation by Health insurance is an important policy of precise poverty alleviation in China.Furthermore health assistance is the last"safety net"of the health security system.Taking Lishui City of Zhejiang Province as a sample,this paper evaluates the bottom effect of poverty alleviation by calculating the changes of the total health self-payment expenses of the rural poor before and after the intervention of health assistance,as well as constructing the relevant indicators of catastrophic health expenditure.It also analyses the impact of individual characteristics and health treatment behavior on catastrophic health expenditure through descriptive statistics and regression model.Finally,this paper puts forward policy suggestions on improving the technical standards of health assistance,establishing a list of medicines for health assistance,and implementing supplementary assistance to poor people in terms of out-of-policy health self-paid expenses.

关 键 词：农村贫困人群 灾难性医疗支出 医疗救助 扶贫效果 制约因素 

分 类 号：F323.89[经济管理—产业经济]