摘要
选取广东省三个代表性地区的大规模医疗保险数据,对职工医保分散大病风险的效果进行了定量分析和模拟测算。从总体上看,参保人的医疗负担还比较重;职工医保在缓解灾难性支出方面作用明显,但整体效果有限。在40%的门槛下,欠发达地区灾难性支出发生率达到29.3%,发达地区也达到了8.5%。相对弱势的中老年群体和低收入群体是灾难性支出发生率最高的群体,但并未受到职工医保的充分照顾。相反,20-39岁的年青群体和高收入阶层成为相对受益最大的群体。从保障水平调整机制、补充医疗保障体系以及医疗救助与职工医保的衔接等三个方面提出了政策建议。
Based the large - scale data of 3 sample cities of Guangdong province, the paper makes a quantitative and simulative analysis on risk diversification effect of serious diseases of China＇s Urban Employees＇ Health Insurance System（UEHIS）. the results show that though UEHIS is playing an important role in reducing the incidence of catastrophic health expendi- ture, its functions are quiet limited. Under the threshold of 40% ,for instance, the Catastrophic Payment Head - count of the less developed areas reaches 29.3 % , even for the developed areas the index is as much as 8.5%. It same that,the elderly people and low -income group,who are relatively disadvantaged social groups and suffering most from the serious diseases, didn＇ t bene- fit adequately from the system. The author suggests that the measures about adjustment mecha- nism of security level and the supplementary medical insurance system should be taken urgent- ly, and coordination between Medical Aid and UEHIS should be enhanced as well.
出处
《人口与发展》
CSSCI
北大核心
2014年第1期33-41,21,共10页
Population and Development
基金
国家社会科学基金重大项目:<新时期中国民生保障体系建设研究>(10&ZD038)
关键词
城镇职工基本医疗保险
医疗负担
大病风险
灾难性支出
UEHIS
burden of medical expenses
risk of serious diseases
Catastrophic HealthExpenditure
