灾难性医疗支出、多层次医疗保障与医疗服务利用——我国大病保险补偿模式评价研究 阅读全文
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Title | Catastrophic Health Expenditure, Multi-level Medical System and Health Care Utilization
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作者 | 朱铭来 于新亮 王美娇 熊先军 |
Author | Zhu Minglai, Yu Xinliang, Wang Meijiao and Xiong Xianjun |
作者单位 | 南开大学经济学院;中国医疗保险研究会 |
Organization | Nankai University;China Health Insurance Research Association |
作者Email | zhuml@nankai.edu.cn;yuxinliang19870906@126.com;wangmeijiao0215@126.com;xiongxianjun@ mohrss.gov.cn |
中文关键词 | 灾难性医疗支出 多层次医疗保障 医疗服务利用 大病保险 |
Key Words | Catastrophic Health Expenditure; Multi-level Medical System; Health Care Utilization; Critical Illness Insurance |
内容提要 | 本文克服以往研究主观设定缺陷,采用国务院城镇居民基本医疗保险评估入户调查数据,构建医疗服务利用对预期价格敏感性差异的面板门槛模型,发现我国灾难性医疗支出标准应为家庭年度医疗服务自负金额占收入的42.90%,并定义特大灾难性医疗支出标准为115.22%;继续构建灾难性医疗支出—收入—健康—医疗服务利用的动态系统模型,模拟六种大病保险模式的补偿效果,研究表明大病保险项目的实施能够有效减轻家庭医疗负担比例(从73.46%降至最低为33.81%),降低灾难性医疗支出发生率(从13%降至6%),而对发生灾难性医疗支出的参保家庭进行补偿的模式不仅在以上两方面更具时效性和稳定性,而且在稳定医疗服务需求和维持基本医保基金可持续方面具有独特的优化功能,模型进一步显示医疗服务产业将处于产能过剩状态。 |
Abstract | To overcome previous studies’ subjective defects, this paper built a threshold panel model based on health care utilization’s different sensitivities to the expected price and found the boundary standard of catastrophic health expenditure in China should be 42.90%; Then this paper built a dynamic system model to simulate the compensation effects of six types of critical illness insurance, and results show that critical illness insurance can effectively reduce the household medical burden and headcount of catastrophic health expenditure, while one type of household compensation has a unique optimization capabilities in steady demand for medical services and basic medical system fund. |
文章编号 | WP1052 |
登载时间 | 2016-04-22 |
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