界定与测量农村居民因病致贫:新型农村合作医疗保险方案研制思路之四

Definition and measurement of rural residents' medical impoverishment:ideas of developing NRCMS(Ⅳ)

借鉴世界银行评价社会贫困状况的方法:(1)将因病致贫界定为农村居民支付超过最大支付能力的医疗费用后致贫的社会现象;(2)从广度和深度两个角度测量因病致贫,采用因病致贫率指标评价广度,采用因病致贫总缺口和因病致贫平均缺口指标评价深度。在此基础上,利用样本地区数据验证了因病致贫界定和测量方法的科学性和合理性。上述方法为新农合管理者合理把握因病致贫,明确回答"消除因病致贫需要筹多少钱"、"因病致贫风险能否解决"提供了技术支撑,为实现"消除因病致贫"的制度目标提供了重点人群。

This paper has developed a new method to define and measure medical impoverishment on the basis of a World Bank approach, which is used to evaluate social poverty. Firstly, medical impoverishment is defined as poverty after medical expenses which exceed a maximum ability-to-pay. Secondly, this poverty is measured in prevalence and severity ： the former is evaluated by rate of medical impoverishment, and the latter by relative poverty gap and average poverty gap. Then, this method has proven to be scientific and reasonable through the data of sample area. Therefore, this method is a technical support for governors to answer ＂what is medical impoverishment＂, ＂if the risk of medical impoverishment could be eliminated＂ and ＂how much funds need to be raised to solve the problem＂. This method also helps to pick up prior groups for achieving policy goals.