银川市退休职工与在职职工医疗保险费用对比分析

Expenditure Comparison of Medical Insurance Between Retirees and Employees in Yinchuan

目的了解银川市退休职工基本医疗保障程度。方法根据2006年银川市医疗保险参保职工的医疗保险缴费数据及医疗消费数据,对退休职工与在职职工的医疗保险费用进行比较。结果(1)基本医疗保险对退休职工住院特诊(住院、特殊疾病门诊就诊)保障程度较高;(2)住院特诊患者中个人支付比例以退休职工为最高;(3)退休职工普通门诊就诊费用相对于在职职工处于较低水平。结论(1)银川市能够较好地保障退休职工大病特殊疾病门诊的医疗需要;(2)基本医疗保险的覆盖面不够,须进一步扩大;(3)退休职工普通门诊费用支出较低,老年人小病医疗需求可能受到抑制;(4)退休人员对今后的医疗费用较为担心且对医疗服务需求有所变化;(5)探索建立老年人口医疗保障制度或老年人口健康疾病补助制度。

Objective To understand the security capacity of medical insurance on Yinchuan＇s retirees.Methods Medical expenditure data were collected and analyzed in Yinchuan in 2006.Results（1）The security capacity on retirees,s inpatient and special outpatient was satisfactory.;（2）Retirees,s individual payment ratio was highger than employee,s;（3）and the mean expenditure of outpatient in retirees was lower than that in employee,s.Conclusion（1）Yinchuan can ensure the need of the retirees＇ serious disease special outpatient;（2）the coverage of the basic medical insurance is insufficient,and must be further expanded;（3）the retirees＇ expenditure of average outpatient is low,the demands of elders＇ slight illness medical service are possibly suppressed;（4）the retirees are worrying about the increasing medical expense,and their demand of the medical service has changed;（5）it is necessary to probe the way of establishing elders medical insurance system and healthy disease assistance system.