确定人群分类:新型农村合作医疗保险方案研制思路之二

Analysis of classifying the rural residents in China:ideas of developing NRCMS(Ⅱ)

从健康状况、年龄、经济水平、就医方式的选择、医疗费用负担等重点影响人群就医经济风险的因素出发,根据这些因素对疾病发生概率或医疗费用高低的影响机制,从横向和纵向两方面区分高危人群、贫困人群、不同就医行为以及不同医疗费用负担4类人群,并介绍了各类人群的界定方法,为准确测量人群就医经济风险分布、合理设计筹资、补偿方案等提供了依据。

The factors that influence people＇s financial risk from medical expenses, such as health status, age, economic status, medical treatment selection style, and medical expense burden were collected. Then, the population was classified into four groups based on the mechanism through which the factors above influence the disease incidence and medical expenses： the high risk group, the low-income group, the different medical behavior group and the different medical expense burden group, and the defining methods of the four groups were provided. Then people＇s financial risk from medical expenses can be accurately measured, and the financing and reimbursement policies can be designed scientifically.