摘要
本研究基于周期理论,将评估模型划分为病前—健康扶贫政策科学性;病中—医疗资源获取公平性;病后—医保报销流程便捷性三大板块。运用文献法与访谈法构建三级指标体系,参考AHP-FCE分析框架,确立评估模型数理化运算逻辑。对凉山州采用分层抽样方法,回收658份有效数据。评估发现,整体结果良好,民众后续参保积极性高;但因病返贫风险点依旧存在;在后脱贫时代凉山州医疗设施设备及医护人才短缺依旧是其突出短板。提出构建因病返贫风险数据动态监测预警机制;加强基层医疗卫生人才队伍和设施设备建设;优化医保业务经办流程,提升医保服务质量;提高群众与医疗机构对医保政策的知晓度等治理对策。
At the end of 2020,the People s Government of Sichuan Province announced that the seven national-level poverty-stricken counties in Liangshan Yi Autonomous Prefecture had successfully alleviated poverty.At this point,Liangshan had completed its strategic task in ending abject poverty,built a moderately prosperous society in all respects,and officially entered the“post-poverty-alleviation era.”This research project,however,finds that health care is a major“weak link”that needs to be overcome in the“post-poverty era”to ensure the gains of poverty alleviation could be maintained.Based on the cycle theory,the study systematically divides the existing medical and health problems in Liangshan.Its evaluation model is divided into three main cycles:1)pre-illness-the scientific nature of health poverty alleviation policies;2)in-illness-equal access to healthcare services;and 3)post-illness-the convenience of medical insurance reimbursement.By using the methodology of literature study and interviews comprehensively,the three main circles can be subdivided into 14 more detailed indicators,such as the government s attention to relevant policies,the public awareness to these policies,the people s satisfaction about the implementation of these policies,and so on.Referring to the analysis framework of the AHP-FCE model,this paper presents an assessment model for the poverty cycle or falling back into poverty due to illness in Liangshan during the post-poverty era,and tries to establish the logic of the model.The research results showed that although the overall results of the healthcare sector in Liangshan were good,the people were excited to sign up for additional insurance,yet the risk of poverty or falling back into poverty due to illness still existed in the“post-poverty alleviation era.”There are multiple ways in which people can slide back into poverty due to illness,including before,during and after an illness.Among them,the shortage of medical facilities and equipment,as well as medical personnel is still a prominent flaw in the medical field.Therefore,this article proposes the following governance countermeasures:1)to establish dynamic monitoring and early warning mechanisms of the risk of poverty or falling back to poverty due to illness;2)to strengthen the training and development of grassroots medical and health personnel,as well as improving facilities and equipment;3)to optimize the health insurance process;4)to improve the quality of medical insurance services;5)and to increase the public and medical institutions awareness of medical insurance policies.The goal hereby is to reduce the likelihood of poverty or regressing into poverty due to illness in Liangshan during the post-poverty era,and to form an effective prevention and control mechanism.
作者
戚兴宇
向洪讯
Qi Xingyu;Xiang Hongxun(School of Public Administration,Southwest Minzu University,Chengdu,610041,Sichuan,China)
出处
《民族学刊》
CSSCI
北大核心
2021年第9期66-73,121,共9页
Journal of Ethnology
基金
国家社科基金项目“凉山彝区脱贫人口返贫风险识别、预警与防范研究”(18BMZ144)
西南民族大学2020年度中央高校专项项目“后脱贫时代凉山州因病致贫、返贫防范机制研究”(2020YYXS31)阶段性成果。
关键词
后脱贫时代
贫困治理
周期评估模型
the post-poverty-alleviation era
poverty governance
cycle evaluation model
作者简介
戚兴宇,男,西南民族大学公共管理学院副教授,博士,硕士研究生导师,研究方向:政府行为与公共政策分析、高等教育管理研究;向洪讯,男,西南民族大学公共管理学院硕士研究生,研究方向:公共政策分析研究。四川成都610041。
