城市医疗救助筹资需求测算及其支出影响因素分析-estimation of financing demand for urban medical assistance and analysis of influencing factors of expenditure.docx

华中科技大学博士学位论文 华 中 科 技 大 学 博 士 学 位 论 文 PAGE 4 PAGE 4 在以经济援助为主要救助方式的情况下，我国城市医疗救助，尤其是住院医疗救 助的申请和利用是以相应医疗救助服务的利用为前提和基础。根据医疗救助利用的程 序，将医疗救助分解为医疗服务利用和救助资格申请两个彼此相对独立又彼此衔接的 过程。分别就影响受访居民医疗卫生服务利用的相关因素和限制受访居民救助资格申 请的相关政策因素对医疗救助利用的影响进行了单因素分析，结果显示：受访居民自 诉健康状况、医疗保障形式、人均月收入、人均月医疗支出、医疗救助实施期限以及 受访居民对医疗救助政策的知晓程度均是影响医疗救助利用的重要因素。 在单因素分析的基础上，进一步构建住院医疗救助利用的概率模型，进行贫困居 民住院医疗救助利用相关因素的多因素分析，结果显示受访对象自评健康状况、月人 均医疗支出、救助政策的知晓程度、住院救助病种范围和住院救助的起付标准等因素 对受访居民住院医疗救助的利用均具有显著性的影响。 关键词： 城市 医疗救助 筹资 需求 利用 影响因素 ABSTRACT Medical Finance Assistance (MFA) is a series of financial, policies and technical assistances to help the poor and disadvantaged groups to access necessary medical services when they are suffering intolerable economic burden of disease, which is supplied by the government or some social organizations. It is an integral part of basic health security system and is considered to be the most direct and effective way to contain health poverty, promote health equity and improve health service quality for the poor people. Establishing and improving MFA system is not only an important public function of modern government, but also and demonstration to protect the basic health rights for people. Since the government launched urban MFA in some pilot cities in 2005, Urban MFA System has developed rapidly in the past 5 years. It has become the bottom of our multi-level health security system. However, compared with developed mature and stable social security system, the Urban MFA system is at a rapid developing and improving stage. There are many technological bottlenecks, such as the conflict between huge health demand and limited MFA funds, high precipitation and low utilization of funds. It is necessary and helpful for us to accurately measure the financing demand and forecast the expenditure of MFA fund, which should be researched and resolved urgently. Objective: This study is aim to building up a calculation model on the basis of reasonably define the scope of urban MFA, develop a relativel