摘要
目的:以浙江省玉环市为例,分析全民医疗保险(以下简称全民医保)政策的实施对当地人群就医负担的影响,为全民医保政策的深化改革提供证据支持。方法:收集玉环市2016年1月—2021年10月的医保报销数据,通过构建间断时间序列回归模型,分析全民医保政策实施后玉环市的医疗费用月总额、医保基金支出月总额与个人现金支出月总额的变化情况。结果:玉环市在2019年1月份开始实施全民医保政策,较政策实施前,医疗费用月总额、医保基金支出月总额的斜率变化差异无统计学意义(P>0.05),但个人现金支出月总额的斜率减少35.02万元/月(P=0.014)。城乡居保患者的医保支出月总额与个人现金支出月总额的斜率分别减少30.54万元/月(P<0.01)与30.87万元/月(P=0.002);城乡居保患者在县域内就诊的医保支出月总额与个人现金支出的月总额的斜率分别减少32.61万元/月(P<0.01)与28.19万元/月(P<0.01);县域内的城乡居保患者发生在医院与基层医疗卫生机构的医保支出月总额与个人现金支出月总额的斜率均有所减少,差异有统计学意义(P<0.01)。结论:全民医保政策的实施减轻了患者的就医负担,应继续深化改革,促进全民医保公平可持续发展。
OBJECTIVE To analyze the impact of the implementation of the universal medical insurance policy on the medical treatment burden of the local population,and to provide evidence for the subsequent deepening reform and development of the universal medical insurance policy.METHODS The medical insurance reimbursement data of Yuhuan from January 2016 to October 2021 were collected,and the interrupted time series regression model was constructed to analyze the changes of the monthly total medical expenditure,the monthly total medical insurance fund expenditure and the monthly total personal cash expenditure in Yuhuan after the implementation of the universal medical insurance policy.RESULTS Yuhuan began to implement the national medical insurance policy in January 2019.Compared with before the implementation of the policy,the slope changes of the monthly total amount of medical expenses and the monthly total amount of medical insurance fund expenses did not have statistical significance(P>0.05),but the slope of the monthly total amount of personal cash expenses decreased by 350200 yuan/month(P=0.014).The slope of total monthly medical insurance expenditure and total monthly personal cash expenditure of urban and rural resident insurance patients decreased by 305400 CNY/month(P<0.01)and 308700 CNY/month(P=0.002),respectively.The slope of total monthly medical insurance expenditure and total monthly personal cash expenditure of urban and rural resident insurance patients in the county were reduced by 326100 CNY/month(P<0.01)and 281900 CNY/month(P<0.01),respectively.The slopes of total monthly medical insurance expenditure and total monthly personal cash expenditure in hospitals and primary health institutions of urban and rural resident insurance patients in the county decreased,and the difference was statistically significant(P<0.01).CONCLUSION The implementation of the universal medical insurance policy has reduced the medical burden of patients.Reform should be further deepened to promote the equitable and sustainable development of the universal medical insurance policy.
作者
刘洪章
罗永松
郑媛
梁笛
黄葭燕
Liu Hongzhang;Luo Yongsong;Zheng Yuan;Liang Di;Huang Jiayan(School of Public Health,Fudan University/Key Laboratory of Health Technology Assessment of National Health Commission(Fudan University),Shanghai,200032,China;不详)
出处
《中国初级卫生保健》
2024年第10期9-14,共6页
Chinese Primary Health Care
关键词
全民医保
间断时间序列分析
疾病经济负担
universal health insurance
interrupted time-series analysis
economic burden of disease
