健康扶贫背景下居民医保对于胃癌患者保障效果研究  

Effects of resident medical insurance on gastric cancer patients in the context of health and poverty alleviation program

作　　者：邹丹丹 李湘君[1] Zou Dandan;Li Xiangjun(Nanjing University of Chinese Medicine,Nanjing 210023,Jiangsu Province,China)

机构地区：[1]南京中医药大学,南京210023

出　　处：《中国医疗管理科学》2021年第6期7-12,共6页Chinese Journal Of Medical Management Sciences

基　　金：大学生创新创业训练计划国家级项目(编号:202010315030)。

摘　　要：目的分析江苏省某市居民医保对低收入胃癌患者的保障效果,探讨低收入人群胃癌患者的疾病经济负担,为提高低收入胃癌患者的保障水平,完善低收入人群医疗保障制度提供参考依据。方法通过描述性统计方法分析该市胃癌患者的社会人口学特征,对比分析医保制度下低收入和非低收入胃癌患者的医疗支出情况,采用多元线性回归方法分析患者人群特征和医疗机构等级对胃癌患者的总医疗支出和自付医疗支出的影响。结果低收入胃癌患者自付医疗支出低于非低收入患者,不同等级医疗机构的就诊人数存在差异,三级医院的就诊人数最高。多元线性回归分析结果表明,年份、性别、医疗机构等级对低收入胃癌患者自付医疗支出的影响存在差异。结论在合理调整各种等级机构医保补偿比例的基础上,适当提升基层医疗机构的医疗服务能力,健康扶贫精准定位于老龄低收入段患者,同时加大大病医保补偿力度,促进患者的健康公平性,以降低疾病负担。Objective To analyze the effects of resident medical insurance on low-income gastric cancer patients in a city in Jiangsu Province,investigate the economic burden of these patients,and provide evidence for improving the insurance system for these patients.Methods Descriptive statistical methods were used to analyze the sociodemographic characteristics of gastric cancer patients in the city,and to compare and analyze the medical expenditures of low-income and other gastric cancer patients under the medical insurance system.Multiple linear regression methods were used to analyze the impact of patients’characteristics and medical institution level on the total and out-of-pocket medical expenditures.Results The out-of-pocket medical expenses of low-income patients with gastric cancer were lower than other patients.There were differences in the number of visits in different medical institutions,while the highest number was in tertiary hospitals.Multiple linear regression analysis showed that there were differences in the impact of year,gender,and level of medical institutions on the out-of-pocket medical expenditures in the low-income gastric cancer patients.Conclusion Based on the reasonable adjustment of the medical insurance compensation ratios of various levels of institutions,the medical service capabilities of primary medical institutions should be improved,and the health and poverty alleviation should target the elderly and low-income patients.At the same time,the compensation for serious illness medical insurance should be increased to promote the health equality and reduce the burden of patients.

关 键 词：胃癌 城镇居民医疗保险 医疗支出 低收入人群 

分 类 号：R197[医药卫生—卫生事业管理]