摘要
目的:对新型农村合作医疗重大疾病保障制度中的病种组合合理性进行评价,并对按病种补偿与按费用补偿之间的衔接情况进行分析。方法:采用现场调查法,通过定性访谈和定量数据分析相结合的方法。结果:22种大病的住院人数占住院总人数的比例为7.9%,重大疾病医疗保障制度按病种补偿后仍能达到按大病保险按费用补偿起付线的人数仅为1%。结论:目前,我国新型农村合作医疗重大疾病按病种补偿政策中的病种组合设计不够合理,大病保险按费用补偿与按病种补偿需要统筹协调,各有侧重,有针对性的设计政策。
Objective:To evaluate the rationality of the disease category of new rural cooperative medical system(NCMS) criticalillness insurance,analyze the relationship between compensation by diseases and compensation by medicine cost.Methods:Qualita-tive analysis and quantitative data analysis were combined to applied the filed investment.Results:The inpatient suffered by the 22 types of illnesses accounted for the total number of hospitalization was 7.9%. The percentage of the patient whose medicine cost com-pensated by critical illness insurance according to the diseases also reached the deductible of the critical illness insurance according tothe cost was 1%.Conclusion:At present,the design of the disease category of the NCMS critical illness insurance was not reason-able. The NCMS critical illness insurance by cost and by disease needed to coordination, with specific designing policy,tended for dif-ferent focus.
出处
《中国卫生经济》
北大核心
2015年第3期62-64,共3页
Chinese Health Economics
基金
2014年北京市自然科学基金青年项目(9144023)
2014年北京市社会科学基金青年项目(14JGC114)
2013年北京市社科联青年社科人才资助项目(2013SKL021)
关键词
新型农村合作医疗
大病保险
病种组合
灾难性卫生支出
new rural cooperative medical system
critical illness insurance
disease category
catastrophic health expenditure
