全民医疗覆盖对降低灾难性卫生支出的效果分析.pdfVIP

全民医疗覆盖对降低灾难性卫生支出的效果分析 吴群红 1* 1 2 1 ，李叶 ，徐玲 ,郝艳华 1. 哈尔滨医科大学卫生管理学院 黑龙江哈尔滨 150081 2. 卫生部卫生信息统计中心 北京 100044 摘要: 中国的医疗保险制度迅速发展，基本实现了全民医疗覆盖。然而，中国仍存在居民 现金卫生支出比例过高的情况，导致家庭由于支付医疗卫生费用而陷入经济困难的窘境。 本文通过计算中国灾难性卫生支出发生率和致贫率，来探究中国医疗保险制度的保障力度 与水平，并通过分析脆弱人群发生灾难性卫生支出风险及影响因素，为今后完善医疗保险 制度设计提供具有可操作性的政策建议，增强其对居民抵御疾病经济风险的保障能力。 关键词：灾难性卫生支出；致贫；全民覆盖；医疗保险 Effect analysis on universal insurance coverage to reduce the incidence of catastrophic health expenditure Wu Qunhong1* 1 2 1 ，Li Ye ，Xu Ling , Hao Yanhua 1. Harbin Medical University, Health Management College, Heilongjiang Harbin,150081 2. Centre of Health Statistics and Information, Ministry of Health, Beijing,100044 Abstract: The medical insurance system of China has developed rapidly and nearly realized universal coverage. However, it is still a common phenomenon that high out-of-pocket expenditure makes Chinese households trapped in the dilemma of economic difficulties by paying for health services. In our study, we calculated the incidence of catastrophic health expenditure and incidence of *基金项目：国家自然科学基金项目；CMB 杰出教授基金(09-979) 作者简介：吴群红，女（1962 年—），博士生导师，主要研究方向为卫生政策； E-mail:wuqunhong@163.com impoverishment by medical expenses, to evaluate the financial protection level of medical insurance system of China. Meanwhile, we also analyzed factors influencing the risk of vulnerable populations who suffered catastrophic health expenditure and provided policy recommendations for the future insurance design on priority areas, which eventually enhance the ability of residents to resist financial risk induced by disease. Keywords catastrophic health expenditure; impoverishment by medical expenses; universal coverage; health insurance 一 背景 中国医保制度覆盖率从 2008 年的 87.9%，拓展到 2012 年的 96%，在不到五年的时间里 中国跃升为医保制度全民覆盖的国家行列。1 医疗保险制度覆盖面的快速拓展，无