农村大病统筹医疗保险方案的关键技术和操作步骤研究概述

An Introduction to Research Project of "Key Techniques and Operative Steps to Formulate Catastrophic Medical Insurance Scheme in Rural China

介绍了课题研究的目的、研究内容、研究方法和具体的资料收集方法等。同时着重介绍了本次研究的主要结果,即本研究研制的农村医疗保险或合作医疗方案制定过程中的关键技术和操作步骤,如特殊人群界定方法,包括贫困测量方法和高危人群界定方法;就医经济风险测量技术;就医经济风险临界线制定技术;静态和动态保险费率的测算方法;以及将上述关键技术与约束条件等有机结合,形成以解决农村居民因病致贫为目的的,在各种社会约束条件范围之内的医疗保险方案。这些方案能动态回答“筹资水平、保障范围和因病致贫”等关键问题。在此基础上,本研究依据调查人群的实际数据模拟分析过程,推荐了农村医疗保险或合作医疗方案研制的操作步骤。

data collection and results on the research project of 'The Study of Key Techniques and Operative Steps of Rural Catastrophic Medical Insurance',especially the main research's results - key techniques and operative steps for scheming rural Catastrophic Medical Insurance (CMI) The key techniques include an identification of the poverty and vulnerable population,a measurement of economic risk for medical service (ERMS), a determination of catastrophic threshold and a contribution rate making. In the end,the above-mentioned key techniques and restrictive conditions are integrated into the prototype of CMI that aims to solve the social problem of impoverished rural residents from sickness. These schemes can give a dymamic answer for the key issue of contribution level,ensure scope and etc. At the same time,this study recommends a series of operative steps to develop the medical insurance or CMS in the light of the procession of data analysis of the sample population