基于委托-代理的农民大病医疗保障模式研究——以湖北省竹山县为例

Research on Medical Insurance Mode for Poor Peasants Suffering from Serious Illness Based on Principal-Agent Theory:Taking the Example of Zhushan Country,Hubei Province

竹山县新农合经办机构基于制度经济学的"委托-代理"理论,并根据县域经济和地域性大病多的特点,以保险经纪人身份与医疗供方联手创新了相同病患群病人临床路径管理的大病医疗保障模式。该模式有效控制了新农合医疗供给中的道德风险,促进了基金的收支平衡;实现了患大病农民以最少的费用支出获得最好医疗照顾的效果。

According to country economic situations and regional characteristics that serious illnesses are widespread and based on the 'principal-agent' theory of institutional economics,the new rural cooperative medical service management agency of Zhushan country created a new serious illnesses medical insurance mode of clinical path management as insurance brokers for the patients suffering same diseases with the medical service supply-side. This mode effectively controlled the moral risk in the supply of new rural cooperative medical service,promoted the payment balance of fund,and provided the peasants suffering serious illnesses much better medical service at the least cost.