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作 者:张沁洁[1] ZHANG Qin-jie(School of Public Management,South China Agricultural University,Guangzhou Guangdong 510642,China)
机构地区:[1]华南农业大学公共管理学院,广东广州510642
出 处:《卫生经济研究》2022年第4期11-14,共4页
基 金:2020年度国家自然科学基金项目“农村相对贫困家庭生计脆弱性测度、形成机理与消减政策优化研究”(72074083);广州市哲学社会科学规划基金项目“广州市社会组织与社区福利治理问题研究”(2019GZYB38);广州市哲学社会科学规划基金项目“政府购买服务下广州社会组织内的竞合关系与资源整合研究”(2017GZYB51)。
摘 要:在全民医保制度框架下,中国儿童实际医疗保障的家庭依赖度及其影响因素值得深究。以儿童实际医疗费用自付比来测量家庭依赖度,发现大多数儿童具有75%以上的高依赖度,有些甚至是完全自付;参保类型、享有医疗保险种数、有否商业医疗保险、是否因病住院、就医次数、是否农业户口和家庭人均纯收入等因素影响家庭依赖度,其中是否因病住院和享受医疗保险种数的影响最为明显。建议适度推进儿童多重医疗保险,改进住院化医保报销方式。Under the framework of the universal medical insurance system, it is worth attention on the family dependence of Chinese children’s medical insurance and its influencing factors. The family dependence is measured by the ratio of children’s actual medical expenses out-of-pocket. Results showed that most children had a high degree of dependence where an out-of-pocket ratio over 75% was observed. Some even reported 100% out-of-pocket ratio. The type of insurance, the number of medical insurance, having commercial medical insurance or not, hospitalization due to illness, number of hospital visits, agricultural household registration, and per capita net income of the family were influencing factors. Among them, hospitalization due to illness and the number of medical insurance showed the strongest association. It is recommended to appropriately promote multiple types of medical insurance for children and improve the reimbursement of hospitalization.
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