城乡居民大病保险实施情况及改进策略研究.pdfVIP

11踊 中国药事 2016 年 12 月第30 卷第12 期 城乡居民大病保险实施情况及改进策略研究 桑晓冬 l ，魏国旭 l ，陈敬 l 气韩晨 1 ，史录文 1 ， 2 ( 1.北京大学药学院，北京 100191; 2. 北 京大学医药管理国际研究中心，北京 100191 ) 摘要 目的:通过梳理我国 31 个省级单位城乡居民大病保险政策的特点、落实情况及实施效果差异，对 比研究国外经验，为我国城乡居民大病保险政策的可持续发展提供建议。方法:文献研究结合实地调研 和访谈，对结果数据进行总结分析，借鉴国外重大疾病保险模式及经验，提出完善我国城乡居民大病保 险的建议。结果:截至2015 年末，我国已有31 个省级单位均已全面实行城乡居民大病保险，但不同省 份对筹资标准、起付线、封顶线和报销比例的政策要求及实施效果存在差异。结论:应建立更加合理的 医疗费用管拉机制，推进医疗保障服务一体化管理，构建筹资动态调节机制和风险联动机制。 关键词: 医疗保障制度;大病保险制度;筹资标准;起付线;封顶线;报销比例 中图分类号: R95 文献标识码:A 文章编号: 1002-7777(2016)12-1183-08 doi: 10.16153/j.1 002-7777.2016.12.003 Implementation and Improvement of Critical IUness Insurance for Urban and Rural Residents l 1 l l Sang Xiaodong , Wei Guoxu , Chen Jing 气 Han Sheng\ Shi Luwen ,2 (1. Scho01 of Phannaceutical Sciences Peking University, Beijing 100191, China; 2. International Research Center ofMedicina1 Adr回回s回.tion， Peking University , Beijing 100191, China) Abstract Objective: To analyze and summariz the characteristics, implementations and effects of the Critica1 Illness Insurance for Urban and Rura1 Residents in 31 provincia1-1eve1 units , and to compare and s阳dy 由e foreign experience, so as to put forward suggestions and ideas for perfecting the critica1 illness insurance for urban and rura1 residents in China. Methods: Literature research combined wi由自e1d surveyw部p町formed， and the results were summarized and analyzed. By drawing lessons 仕om foreign major disease insurance mode and experience，~础onsw四川伽wardωimprove the serio田illn部insurance ofmban and rura1 residents 也αina. Results: China had implemented a critica1 illness insurance 倒也e end of2015, but 也e policy 岛Ir urban and rural residents and implementation effect varied among different provinces. Conclusion: It is necessary to establish reasonable mechanism of control1ing medical costs, prom