摘要
了解健康扶贫政策实施以来,国家定点扶贫县贫困患病人群的医疗费用负担,探究健康扶贫政策实施效果及不足。通过比较2016—2018年4个国家定点扶贫县贫困患病人群医疗费用情况、医疗费用分担构成以及住院和门诊费用差异,发现健康扶贫政策在减贫控费上取得成效,贫困患者不同年份、不同地域医疗费用都存在明显差异,医疗总费用呈上升趋势,而个人自费费用负担并未加重。医疗费用补偿以新型农村合作医疗(简称新农合)为主,医保资金压力大,其他补偿作用不明显;慢性病患者增多,慢性病费用占总医疗费用的64.66%,加重了医疗负担。建议继续加强健康扶贫政策作用,提高贫困患者医疗保障政策的精准化、公平性,减轻患者疾病负担,提高贫困患者获得感。加强与慈善组织的合作,稳定筹资渠道,健全大病保障机制,提高分类救治效果,增强农村地区慢性病健康管理,完善基层医疗服务体系建设。
The study main purpose to understand the burden of medical expenses of the poor patients in the four fixed⁃point poverty alleviation countries since the implementation of health poverty alleviation,and to explore the effects and shortcomings of the implementation of health poverty alleviation.By comparing the medical expenses,the composition of medical expenses sharing,and the difference expenses of the hospitalization and outpatient in the poverty⁃stricken population in the four depth poverty⁃stricken countries from 2016 to 2018.It is found that the implementation of the health poverty alleviation policy has achieved results in poverty reduction and medical costs control.There are significant differences in medical expenses of the poor patients in different years and different regions.The total medical expenses are on the rise,and the burden of personal out⁃of⁃pocket expenses has not increased.The compensation for medical expenses is mainly based on the new rural cooperative medical system(NCMS),medical healthcare insurance fund is under pressure,and other compensation effect is not obvious.Secondly,the number of chronic disease patients is increases,and it costs accounted for 64.66%of the total medical costs.It aggravated the state of disease.It is recommended to strengthen the role of the health poverty alleviation policy,improve the precision and fairness of the medical security policy for the poor patients,and reduce the burden of disease and improve the sense of contentment of the poor patients.Strengthen the cooperation with other charitable organizations,stabilize the funding channels,improve the protection mechanism for major diseases,improve the effectiveness of classified treatment,enhance the health management of chronic diseases in rural areas,and the construction of the primary health institutions.
作者
张思思
刘平
魏嘉诚
王振邦
ZHANG Sisi;LIU Ping;WEI Jiacheng;WANG Zhenbang(School of Public Health,Fujian Medical University,Fuzhou 350122;Department of Science and Education,Fujian Cancer Hospital,Fuzhou 350014,China)
出处
《南京医科大学学报（社会科学版）》
2020年第6期504-509,共6页
Journal of Nanjing Medical University（Social Sciences）
基金
福建省自然基金项目“福建省因病支出型相对贫困长效治理机制研究”(2020J01582)
教育部人文社科项目“社会质量视角下贫困户‘脱贫摘帽’后可持续生计问题研究”(17YJC840011)。
关键词
健康扶贫
患病人群
医疗费用
住院
门诊
health poverty alleviation
patients
medical expense
hospitalization
outpatient
