我国基本医疗保险政策减贫研究:进展、困局与展望  

Research on Poverty Alleviation in China’s Basic Medical Insurance Policy:Progress,Dilemmas and Prospects

作　　者：段颖 张良文[1] 朱培嘉 方亚[1] Duan Ying;Zhang Liangwen;Zhu Peijia(Key Laboratory for Health Technology Assessment,Center for Geriatric Health Research,School of Public Health,Xiamen University,Xiamen,Fujian,361102,China;不详)

机构地区：[1]厦门大学公共卫生学院老年健康研究中心、卫生技术评估福建省高校重点实验室,福建厦门361102

出　　处：《中国卫生经济》2024年第4期21-25,共5页Chinese Health Economics

基　　金：国家自然科学基金(81973144);2022年福建省社会科学基金(FJ2022C047)。

摘　　要：目的:系统梳理国内外医疗保险减贫效应评价研究进展,为充分发挥我国基本医疗保险的减贫作用提供政策建议。方法:采用文献研究法,归纳医疗保险减贫效应评价的测度标准,厘清实现减贫效应的作用机制,分析国内外医疗保险减贫的主要成效及差异。结果:学者对于国内外医疗保险的减贫效应多数持肯定观点,但尚未得到较统一的结论。采用的测度标准包括贫困脆弱性、灾难性卫生支出、多维贫困指数等。减贫效应主要通过减少支出总量(直接机制)及增加人力资本投资(间接机制)等途径实现。然而,目前我国基本医疗保险的发展面临着政策制定与减贫资源的传递缺乏精准性等诸多挑战。结论:建议综合分析由基本医疗保险和大病保险等构成的多层次医疗保障体系的减贫效应,采取多维贫困测度标准科学、合理地评价基本医疗保险的减贫效应。Objective:It aims to systematically review the research progress on evaluating the poverty reduction effect of medical insurance and provide policy recommendations for maximizing its role in reducing poverty.Methods:Literature review is applied to summarize measurement standards for evaluating the foreign and domestic poverty reduction effect,clarify the implementation mechanisms,and analyze the effectiveness and variations of medical insurance-driven poverty reduction domestically and internationally.Results:Most scholars hold a positive view of the poverty reduction effect of domestic and foreign health insurance,but have not yet reached a more unified conclusion.Measurement standards include poverty vulnerability,catastrophic health expenditures,and multidimensional poverty index.The poverty reduction effect primarily stems from reducing total expenditure(direct mechanism)and increasing human capital investment(indirect mechanism).However,the development of basic health insurance in China currently faces a number of challenges,including a lack of precision in policy formulation and delivery of resources for poverty reduction.Conclusion:It is recommended that a comprehensive analysis be made of the poverty-reducing effects of the multilevel medical insurance system,consisting of basic medical insurance and major disease insurance,and that multidimensional poverty-measuring criteria be adopted to scientifically and reasonably evaluate the poverty-reducing effects of basic medical insurance.

关 键 词：基本医疗保险 减贫 进展 困局 展望 

分 类 号：R1-9[医药卫生—公共卫生与预防医学] R19-0